Individual provider Active NPI

Toren Sidney Davis Jr.

  • Family Medicine Physician
  • Vancouver, WA
National Provider Identifier
1457779498
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
201700719 Issued in NC
Practice address
100 E 33Rd St Ste 100
Vancouver, WA 98663-2776
Phone
(360) 514-7550
Fax
(360) 514-7553
NPI assigned
Apr 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP61185758 WA
Family Medicine Physician 207Q00000X 201700719 NC Primary

Addresses

Primary practice location

100 E 33Rd St Ste 100
Vancouver, WA 98663-2776

Mailing address

PO Box 936857
Atlanta, GA 31193-6857
Phone (910) 763-5522

Other practice location 1

2523 Delaney Ave
Wilmington, NC 28403-6003
Phone (910) 667-9402

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tdavis78962@direct.nhrmc.org
Direct Messaging Address tdavis78962@direct.nhrmc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170619001542 NC Practitioner - Family Practice 7810113867 Reassigns benefits to 1 organization
I20211006000930 WA Practitioner - Family Practice 7810113867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 9739092065, 101 clinicians

Practice addresses (Care Compare)

100 E 33Rd St
Suite 100
Vancouver, WA 98663-2776
Phone (360) 256-2000

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201700719NCMDFamily Medicine Physician
OP61185758WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Family Medicine CurrentSince Sep 27, 2021 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC Current Accepting new patients
Novant Health New Hanover Regional Medical Center LLC CurrentSince Feb 1, 2021 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC Family Medicine CurrentSince Feb 1, 2021 Accepting new patients

Locations

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

2221 S 17th St
Wilmington, NC 28401
Phone (910) 662-7720

2523 Delaney Ave
Wilmington, NC 28403
Phone (910) 763-5522

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

100 E 33rd St
Ste 100
Vancouver, WA 98663
Phone (360) 514-7550

Interoperability endpoints

  • Direct secure messaging: tdavis534041@direct.peacehealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1396742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1457779498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857",
            "telephone_number": "910-763-5522",
            "fax_number": "910-763-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 33RD ST STE 100",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986632776",
            "telephone_number": "360-514-7550",
            "fax_number": "360-514-7553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2523 Delaney Ave",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284036003",
            "country_code": "US",
            "telephone_number": "910-667-9402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TOREN",
        "middle_name": "SIDNEY",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-06",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61185758",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "201700719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tdavis78962@direct.nhrmc.org",
            "affiliation": "N",
            "address_1": "2523 Delaney Ave",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284036003",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tdavis78962@direct.nhrmc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2523 S. 17th Street",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284036003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.