Donica J Davis, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7390 Issued in GA

Practice address

1336 Hwy 54 West BLDG 200
Fayetteville, GA 30214-3211

Phone

(770) 460-9777

NPI assigned

Sep 22, 2005

Last updated

Dec 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Donica J Bravick Former name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: donica.davis.p1@direct.gupa.nextgenshare.com

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.

• Georgia Urology Piedmont, LLC

  • Urology Physician
  • Conyers, GA
  • NPI 1376163451
  Medicare reassignment NPD
• Georgia Urology PA

  • Urology Physician
  • Riverdale, GA
  • NPI 1245250646
  Medicare reassignment
• Georgia Urology PA

  • Urology Physician
  • Fayetteville, GA
  • NPI 1942426168
  NPD
• Georgia Urology, PA

  • Ambulatory Surgical Clinic/Center
  • Braselton, GA
  • NPI 1861222119
  NPD
• Prevea Regional Services, Inc.

  dba Prevea Regional

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1194748061
  NPD (past)

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1447246780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 BRANNAN RD.",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "30253",
            "telephone_number": "678-284-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 HWY 54 WEST BLDG 200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143211",
            "telephone_number": "770-460-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DONICA",
        "middle_name": "J",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1259",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONICA",
            "last_name": "BRAVICK",
            "middle_name": "J",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Monique R Darnell, LPC
• Jalpa Harvadan Dave, DMD
• Alan D Davis, M.D.
• Cherie Davis
• Debbie S. Davis, MSN
• Gregory Scott Davis, PHARMD
• Kendall Davis, RBT
• Megan Laverne Davis
• Meghan Davis, RN
• Mitzie-Ann Davis, MD

• Physician Assistant in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.