Davis Grove Pediatrics PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2008-00550 Issued in NC

Legal business name

DAVIS GROVE PEDIATRICS PLLC

Practice address

204 Davis Grove Cir Ste 107
Cary, NC 27519-2581

Phone

(919) 363-3427

Fax

(919) 363-3437

NPI assigned

Jan 15, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jim Yan, PH.D.

Title

Manager

Phone

(919) 452-4761

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Zhao Min, M.D.

  • Sleep Medicine (Family Medicine) Physician
  • Cary, NC
  • NPI 1821282948

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452816000000",
    "number": "1457718835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 DAVIS GROVE CIR STE 107",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275192581",
            "telephone_number": "919-363-3427",
            "fax_number": "919-363-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 DAVIS GROVE CIR STE 107",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275192581",
            "telephone_number": "919-363-3427",
            "fax_number": "919-363-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS GROVE PEDIATRICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-01-15",
        "status": "A",
        "authorized_official_last_name": "YAN",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "919-452-4761",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2008-00550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910793",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Davie, LCSWA
• Caitlin Davies, OTR/L
• Courtney Anne Davies, M.S.-CCC
• James R Davies, D.D.S.
• Samantha Pauline Davies, PT, DPT
• Arieyona Lamara Davis, BEHAVIOR TECHNICIAN
• Ashley Davis
• Camille Triona Deshon Davis
• Charles Brandon Davis, PHARMD
• Ervin Davis Jr., LCSW-A

• Pediatrics Physician in Cary, NC
• Providers in Cary, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.