Individual provider Active NPI

Justin Michael Davies, M.D.

  • Internal Medicine Physician
  • Grand Rapids, MI
National Provider Identifier
1376807933
Registry record updated Dec 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301101550 Issued in MI
Practice address
3355 Eagle Park Dr NE Ste 103
Grand Rapids, MI 49525-7004
Phone
(616) 942-7400
Fax
(616) 942-7405
NPI assigned
Jun 28, 2012
Last updated
Dec 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301101550 MI Primary

Addresses

Primary practice location

3355 Eagle Park Dr NE Ste 103
Grand Rapids, MI 49525-7004

Mailing address

PO Box 639295 Dept 93394
Cincinnati, OH 45263-9295
Phone (484) 346-1692

Other practice location 1

1877 N Getty St
N Muskegon, MI 49445-8563
Phone (231) 728-5052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150917002808 MI Practitioner - Internal Medicine 6901113240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Human Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vpa PCGroup PAC ID 9234041948, 181 clinicians

Practice addresses (Care Compare)

Okemos, MI 48864
Phone (517) 347-4085

Grand Rapids, MI 49546
Phone (616) 942-7400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Internal Medicine CurrentSince Dec 1, 2022 Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC Internal Medicine CurrentSince Dec 1, 2022 Accepting new patients
Iah of Michigan, PLLC Internal Medicine PastSince Dec 28, 2022 Accepting new patients

Locations

3355 Eagle Park Dr NE
Ste 103
Grand Rapids, MI 49525
Phone (616) 942-7400

2205 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 347-4085

2205 Jolly Rd
Ste A
Okemos, MI 48864
Phone (517) 347-4085

Interoperability endpoints

  • Direct secure messaging: justin.davies.1@32913.direct.athenahealth.com
  • Direct secure messaging: jdavies32582@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1340841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1376807933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639295 DEPT 93394",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639295",
            "telephone_number": "484-346-1692",
            "fax_number": "556-186-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 EAGLE PARK DR NE STE 103",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257004",
            "telephone_number": "616-942-7400",
            "fax_number": "616-942-7405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1877 N Getty St",
            "address_purpose": "LOCATION",
            "city": "N Muskegon",
            "state": "MI",
            "postal_code": "494458563",
            "country_code": "US",
            "telephone_number": "231-728-5052",
            "fax_number": "231-728-5086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "JUSTIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-28",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301101550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.