Individual provider Active NPI

Todd Davis, D.O.

  • Emergency Medicine Physician
  • Chandler, AZ
National Provider Identifier
1457307282
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
3745 Issued in AZ
Practice address
475 S Dobson Rd
Chandler, AZ 85224-5605
Phone
(480) 917-1648
NPI assigned
May 25, 2006
Last updated
Apr 21, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 3745 AZ
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X 3745 AZ
Emergency Medicine Physician 207P00000X 3745 AZ Primary

Addresses

Primary practice location

475 S Dobson Rd
Chandler, AZ 85224-5605

Mailing address

12205 N 138TH St
Scottsdale, AZ 85259-3761

Other identifiers 1

IdentifierTypeStateIssuer
AZ0736120OtherAZBC/BS

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
I20040217001142 AZ Practitioner - Emergency Medicine 1355236415 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3745AZMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chandler Emergency Medical Group, LLC Emergency Medicine CurrentSince Jul 1, 2003 Accepting new patients
Critical Care Consultants LLC Current Accepting new patients
Valley Hyperbarics LLC CurrentSince Feb 16, 2004 Accepting new patients
Ingenuity Medical Group LLC Emergency Medicine Past Accepting new patients

Locations

1955 W Frye Rd
Chandler, AZ 85224
Phone (480) 507-2961

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

1930 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 532-1000

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.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271808000000",
    "number": "1457307282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12205 N 138TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852593761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 S DOBSON RD",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245605",
            "telephone_number": "480-917-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2010-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "AZ",
            "license": "3745",
            "primary": false
        },
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": "AZ",
            "license": "3745",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "3745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "AZ0736120",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.