Individual provider Active NPI

Julia R Davis, MD

  • General Practice Physician
  • Prescott, AZ
National Provider Identifier
1396206603
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
68100 Issued in AZ
Practice address
3124 Willow Creek Rd
Prescott, AZ 86301-6610
Phone
(870) 798-4299
Fax
(928) 433-0730
NPI assigned
Mar 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X E-14440 AR
General Practice Physician 208D00000X 68100 AZ Primary

Addresses

Primary practice location

3124 Willow Creek Rd
Prescott, AZ 86301-6610

Mailing address

3124 Willow Creek Rd
Prescott, AZ 86301-6610
Phone (870) 798-4299

Other identifiers 1

IdentifierTypeStateIssuer
1396206603OtherARNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20231218002874 AZ Practitioner - General Practice 7517291669 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prescott Medical Investment LLCGroup PAC ID 5092151696, 4 clinicians
West Coast Wound and Skin Care IncGroup PAC ID 7315212834, 30 clinicians

Practice addresses (Care Compare)

1110 E Route 66
Suite 100
Flagstaff, AZ 86001-4772
Phone (928) 773-9695

1710 W Southern Ave
Mesa, AZ 85202-4800
Phone (480) 644-7900

3124 Willow Creek Rd
Prescott, AZ 86301-6610
Phone (928) 445-7085

3706 Hwy 95
Suite 101
Bullhead City, AZ 86442-8226
Phone (818) 856-9535

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue201
Removal of skin lesions17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prescott Medical Investment LLC CurrentSince Nov 1, 2024 Accepting new patients
West Coast Wound and Skin Care Inc CurrentSince Oct 21, 2024 Accepting new patients
Serve MD LLC Past Accepting new patients

Locations

3706 Highway 95
Ste 101
Bullhead City, AZ 86442
Phone (928) 201-9286

3124 Willow Creek Rd
Prescott, AZ 86301
Phone (928) 371-4700

2501 W Burbank Blvd
Ste 200
Burbank, CA 91505
Phone (818) 732-8272

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EECFDD

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.

NPI Registry JSON

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1396206603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863016610",
            "telephone_number": "870-798-4299",
            "fax_number": "870-798-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863016610",
            "telephone_number": "870-798-4299",
            "fax_number": "928-433-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JULIA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AR",
            "license": "E-14440",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AZ",
            "license": "68100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1396206603",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

Verify at the official NPI Registry.