NPIMap

Individual provider Active NPI

James M Davis III, M.D.

  • Diagnostic Radiology Physician
  • Winston Salem, NC
National Provider Identifier
1396796322
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35871 Issued in NC
Practice address
3155 Maplewood Ave
Winston Salem, NC 27103-3903
Phone
(336) 794-4372
Fax
(336) 659-2379
NPI assigned
May 15, 2006
Last updated
Sep 14, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 35871 NC
Diagnostic Radiology Physician 2085R0202X 35871 NC Primary

Addresses

Primary practice location

3155 Maplewood Ave
Winston Salem, NC 27103-3903

Mailing address

3010 Trenwest Dr
Winston Salem, NC 27103-3208
Phone (336) 970-5000

Other identifiers 2

IdentifierTypeStateIssuer
P00605576OtherNCRAILROAD MEDICARE
5904202MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Health Systems Corp. Past Accepting new patients
Open Air MRI Centers Medical Group, Inc. Diagnostic Radiology Past Accepting new patients
Palmetto Imaging, LLC Diagnostic Radiology PastSince Aug 1, 2017 Accepting new patients
La Jolla Radiology Medical Group - Diagnosis, Inc. Diagnostic Radiology Past Accepting new patients
Imaging Healthcare Specialists Medical Group, Inc. Diagnostic Radiology PastSince Oct 14, 2013 Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1396796322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 TRENWEST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033208",
            "telephone_number": "336-970-5000",
            "fax_number": "336-970-5298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 MAPLEWOOD AVE",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033903",
            "telephone_number": "336-794-4372",
            "fax_number": "336-659-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAMES",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NC",
            "license": "35871",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "35871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00605576",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5904202",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.