Mark Joel Davis, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

ME0065723 Issued in FL

Practice address

141 Coconut Dr
Indialantic, FL 32903-2607

Phone

(321) 610-8939

Fax

(321) 622-8728

NPI assigned

Aug 15, 2005

Last updated

Aug 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Vip Neurology

  • Neurology Physician
  • Merritt Island, FL
  • NPI 1659774685
  NPD
• Gulf Coast Hma Physician Management LLC

  dba Gulf Coast Medical Group

  • Internal Medicine Physician
  • Venice, FL
  • NPI 1407806094
  NPD (past)
• Punta Gorda Hma Physician Management LLC

  dba Davis Orthopedic Center

  • Orthopaedic Surgery Physician
  • Port Charlotte, FL
  • NPI 1508163858
  NPD (past)
• Stewart and Stewart a Medical Corporation

  dba Stewart Medical Group

  • Family Medicine Physician
  • Alhambra, CA
  • NPI 1306058565
  NPD (past)

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1386646800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 COCONUT DR",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329032607",
            "telephone_number": "321-610-8939",
            "fax_number": "321-622-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 COCONUT DR",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329032607",
            "telephone_number": "321-610-8939",
            "fax_number": "321-622-8728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1951B Tamiami Trl",
            "address_purpose": "LOCATION",
            "city": "Port Charlotte",
            "state": "FL",
            "postal_code": "339482112",
            "country_code": "US",
            "telephone_number": "941-613-3800",
            "fax_number": "941-613-3804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MARK",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME0065723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250063900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline Cubero
• Ashley Diane Curtis, NP
• Joseph Robert Cwikla, DMD
• Dale P Greyslak PA PLLC
• Maricruz Davis, MSN, APRN, FNP-C
• Rebekah Jayne Dean, RDN
• Antoine Deleuze, PTA
• Yelba Mercedes Delgado, MS CCC-SLP
• Denny Ragsdale MD Inc
• Meghan Derousse

• Orthopaedic Surgery Physician in Indialantic, FL
• Providers in Indialantic, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.