NPIMap

Individual provider Active NPI

Timothy Mark Davis, MD

  • Hematology & Oncology Physician
  • Abingdon, VA
National Provider Identifier
1407896947
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
0101241203 Issued in VA
Practice address
16000 Johnston Memorial Dr
Abingdon, VA 24211-7659
Phone
(276) 258-1800
Fax
(276) 619-2497
NPI assigned
Jun 6, 2006
Last updated
May 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101241203 VA
Hematology & Oncology Physician 207RH0003X 33807 NC
Hematology & Oncology Physician 207RH0003X 0101241203 VA Primary
Medical Oncology Physician 207RX0202X 010241203 VA
Medical Oncology Physician 207RX0202X 36421 WV

Addresses

Primary practice location

16000 Johnston Memorial Dr
Abingdon, VA 24211-7659

Mailing address

16000 Johnston Memorial Dr
Abingdon, VA 24211-7659
Phone (276) 258-1800

Other practice location 1

3415 MacCorkle Ave SE
Charleston, WV 25304-1334
Phone (304) 388-8380

Other identifiers 3

IdentifierTypeStateIssuer
010413133MedicaidVA
8927879MedicaidNC
1407896947MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260319003629 WV Practitioner - Medical Oncology 7719950559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
University of Virginia School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3415 Maccorkle Ave SE
Charleston, WV 25304-1334
Phone (304) 388-8380

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33807NCMDHematology & Oncology Physician
0101241203VAMDHematology & Oncology Physician
010241203VAMDMedical Oncology Physician
36421WVMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation Internal Medicine PastSince Aug 1, 2015 Accepting new patients
Cancer Outreach Associates, P.C. Past Accepting new patients
Cancer Outreach Associates, P.C. Past Accepting new patients

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1407896947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16000 JOHNSTON MEMORIAL DR",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242117659",
            "telephone_number": "276-258-1800",
            "fax_number": "276-619-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 JOHNSTON MEMORIAL DR",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242117659",
            "telephone_number": "276-258-1800",
            "fax_number": "276-619-2497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3415 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041334",
            "country_code": "US",
            "telephone_number": "304-388-8380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TIMOTHY",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101241203",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "33807",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "VA",
            "license": "0101241203",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "VA",
            "license": "010241203",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "WV",
            "license": "36421",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010413133",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8927879",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407896947",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

Verify at the official NPI Registry.