Individual provider Active NPI

Arthur Griffin Davis, NP-C

  • Family Nurse Practitioner
  • Tifton, GA
National Provider Identifier
1366962227
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN200024 Issued in GA
Practice address
612 Love Ave
Tifton, GA 31794-4406
Phone
(229) 391-3300
Fax
(229) 388-1948
NPI assigned
Jun 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN200024 GA Primary

Addresses

Primary practice location

612 Love Ave
Tifton, GA 31794-4406

Mailing address

612 Love Ave
Tifton, GA 31794-4406
Phone (229) 391-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170824000145 GA Practitioner - Nurse Practitioner 8527330679 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

612 Love Ave
Tifton, GA 31794-4406
Phone (229) 391-3300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN200024GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Care Medical Center LLC CurrentSince Apr 20, 2019 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince May 15, 2018 Accepting new patients
Care Medical Center LLC CurrentSince Apr 20, 2019 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince May 15, 2018 Accepting new patients

Locations

306 Shirley Ave
Douglas, GA 31533
Phone (229) 241-8925

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

612 Love Ave
Tifton, GA 31794
Phone (229) 391-3300

162 Virginia Ave S
Tifton, GA 31794
Phone (229) 241-8925

2804 N Oak St
Ste C
Valdosta, GA 31602
Phone (229) 241-8925

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366962227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 LOVE AVE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944406",
            "telephone_number": "229-391-3300",
            "fax_number": "229-388-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 LOVE AVE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944406",
            "telephone_number": "229-391-3300",
            "fax_number": "229-388-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ARTHUR",
        "middle_name": "GRIFFIN",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN200024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.