Individual provider Active NPI

Joshua Paul Davis

  • Certified Registered Nurse Anesthetist
  • Provo, UT
National Provider Identifier
1417465295
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
62075144406 Issued in UT
Practice address
1034 N 500 W
Provo, UT 84604-3380
Phone
(801) 357-7850
NPI assigned
Jan 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 6201556-3102 UT
Registered Nurse 163W00000X RN9407699 FL
Registered Nurse 163W00000X 0001277405 VA
Certified Registered Nurse Anesthetist 367500000X 0024175977 VA
Certified Registered Nurse Anesthetist 367500000X 62075144406 UT Primary

Addresses

Primary practice location

1034 N 500 W
Provo, UT 84604-3380

Mailing address

1257 S 400 E
Springville, UT 84663-2421
Phone (435) 313-1678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180507002025 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931463502 Reassigns benefits to 1 organization
I20211202002394 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931463502 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Gastroenterology LLCGroup PAC ID 9830174150, 71 clinicians

Practice addresses (Care Compare)

6360 S 3000
Suite 310
Salt Lake City, UT 84121-6939
Phone (801) 944-3188

Merit-based Incentive Payment System (MIPS)

Final score
75.45 of 100Reported as group
Quality
47.08
Promoting interoperability
95
Improvement activities
40
Cost
75.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9407699FLMDRegistered Nurse
6201556-3102UTMDRegistered Nurse
0001277405VAMDRegistered Nurse
62075144406UTMDCertified Registered Nurse Anesthetist
0024175977VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Virginia PC CurrentSince Mar 2, 2018 Accepting new patients
Utah Gastroenterology LLC Current Accepting new patients
Utah Gastroenterology CurrentSince Jun 1, 2023 Accepting new patients
Mountain West Anesthesia LLC CurrentSince Oct 1, 2021 Accepting new patients
American Anesthesiology of Virginia, PC CurrentSince Mar 2, 2018 Accepting new patients
Utah Gastroenterology LLC Current Accepting new patients

Locations

620 Medical Dr
Ste 205
Bountiful, UT 84010
Phone (801) 298-0057

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

6360 S 3000 E
Ste 310
Salt Lake Cty, UT 84121
Phone (801) 944-3144

1187 E 3900 S
Salt Lake Cty, UT 84124
Phone (801) 263-3041

150 W Civic Center Dr
Ste 200
Sandy, UT 84070
Phone (801) 727-2056

368 E Riverside Dr
Ste A
St George, UT 84790
Phone (435) 673-1149

1001 Sam Perry Blvd
Fredericksburg, VA 22401
Phone (540) 741-1100

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

Interoperability endpoints

  • FHIR API: https://4af267b3-0b17-4e37-b82c-3c19f9bce5de.gastro.prod.fhir.ema-api.com/fhir/r4/

Organizations & group practices 6

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": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1417465295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 S 400 E",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846632421",
            "telephone_number": "435-313-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043380",
            "telephone_number": "801-357-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOSHUA",
        "middle_name": "PAUL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-16",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "6201556-3102",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9407699",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001277405",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024175977",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "62075144406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.