William Wilder Davis III, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

4301105368 Issued in MI

Practice address

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746

Phone

(616) 363-7272

Fax

(616) 361-5828

NPI assigned

Mar 31, 2014

Last updated

Jul 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, TX, WA, ID4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Diagnostic Radiology

Education

Wayne State University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-State Memorial HospitalGroup PAC ID 4082502422, shared by 3 NPIs, 33 clinicians

Vannvei LLCGroup PAC ID 1254743420, 19 clinicians

High Plains Radiological Association LLPGroup PAC ID 9739172479, 36 clinicians

Phoenix Radiology, PLLCGroup PAC ID 1254390354, 8 clinicians

Open Air Imaging Center LLPGroup PAC ID 9739258310, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003
• Bsa Hospital Hospital, Amarillo, TX, CCN 450231
• Syringa General Hospital Hospital, Grangeville, ID, CCN 131315
• Glen Rose Medical Center Hospital, Glen Rose, TX, CCN 450451
• Lovelace Regional Hospital - Roswell Hospital, Roswell, NM, CCN 320086

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wdavis282887@direct.hfhs.org
• Direct secure messaging: wdavis836784@ahs.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• High Plains Radiological Association LLP

  • Diagnostic Radiology Physician
  • Amarillo, TX
  • NPI 1205897360

  MI

  Medicare reassignment Care Compare group NPD
• Open Air Imaging Center, LLP

  • Radiology Clinic/Center
  • Amarillo, TX
  • NPI 1609982131
  Medicare reassignment Care Compare group NPD
• Phoenix Radiology, PLLC

  • Vascular & Interventional Radiology Physician
  • Lewiston, ID
  • NPI 1164493334

  Diagnostic Radiology

  Medicare reassignment Care Compare group NPD
• Vannvei LLC

  • Multi-Specialty Clinic/Center
  • Lewiston, ID
  • NPI 1881200517
  Medicare reassignment Care Compare group
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1598814352
  Medicare reassignment NPD
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1760485221
  Medicare reassignment NPD
• Tri-State Memorial Hospital

  • Community Based Hospice Care Agency
  • Clarkston, WA
  • NPI 1831100254
  NPD
• Tri-State Memorial Hospital

  dba Tri State Medical Clinics

  • Family Medicine Physician
  • Clarkston, WA
  • NPI 1932405693
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bsa Hospital LLC

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1407191984
  Care Compare affiliation
• Lovelace Health System LLC

  dba Lovelace Regional Hospital-Roswell

  • General Acute Care Hospital
  • Roswell, NM
  • NPI 1972878361
  Care Compare affiliation
• Somervell County Hospital District

  dba Glen Rose Medical Center

  • Rural Acute Care Hospital
  • Glen Rose, TX
  • NPI 1700826575
  Care Compare affiliation
• St Joseph Hospital LLC

  • Oxygen Equipment & Supplies (DME)
  • Lewiston, ID
  • NPI 1992231799

  Hospital

  Care Compare affiliation
• St. Joseph Hospital LLC

  dba St. Joseph Regional Medical Center

  • General Acute Care Hospital
  • Lewiston, ID
  • NPI 1225090954
  Care Compare affiliation
• Syringa General Hospital District C I F

  • Critical Access Hospital
  • Grangeville, ID
  • NPI 1750336608
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595980800000",
    "number": "1356769004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7272",
            "fax_number": "616-361-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WILLIAM",
        "middle_name": "WILDER",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301105368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Beckman Davis, MD
• Shawn M Davis, RN
• Shelly Hennink Davis, OTR
• Tracy Katherine Davis, M.A., LLPC
• Tristen Davis
• Linsey Rae Davison, AGACNP-BC
• Mubarak Alhassan Dawaki, M.D.,
• Janna Dawdy, RN
• Christian Douglas Dawe, PT, DPT
• Denise Catherine Dawley, MD

• Diagnostic Radiology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Diagnostic Radiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.