Individual provider Active NPI

Paul W Davis, MD

  • Family Medicine Physician
  • Anchorage, AK
National Provider Identifier
1467462887
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2541 Issued in AK
Practice address
1201 E 36TH Ave
Anchorage, AK 99508-4372
Phone
(907) 562-9229
Fax
(907) 562-1603
NPI assigned
Aug 8, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2541 AK Primary

Addresses

Primary practice location

1201 E 36TH Ave
Anchorage, AK 99508-4372

Mailing address

PO Box 196276
Anchorage, AK 99519-6276
Phone (907) 565-6522

Other identifiers 1

IdentifierTypeStateIssuer
MD2541MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 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
I20080915000366 TX Practitioner - Family PracticePractitioner - General Surgery 6709952880 Reassigns benefits to 2 organizations
I20140618000277 AK Practitioner - Family Practice 6709952880 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol Bay Area Health Corporation Current Accepting new patients
Norton Sound Health Corporation Family Medicine Current Accepting new patients
South Peninsula Hospital, Inc CurrentSince Jun 12, 2015 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corportion Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Jul 1, 2008 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Feb 3, 2011 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
South Peninsula Hospital, Inc. Family Medicine CurrentSince Jun 12, 2015 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation CurrentSince Jul 1, 2008 Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corporation Current Accepting new patients
Bristol Bay Area Health Corportation Current Accepting new patients
Bristol Bay Area Health Corportion Current Accepting new patients
Homer Medical Clinic, a Professional Corp Family Medicine PastSince Dec 1, 2014 Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

4201 Bartlett St
Ste 202
Homer, AK 99603
Phone (907) 235-7000

4300 Bartlett St
Homer, AK 99603
Phone (907) 235-0369

Interoperability endpoints

  • Direct secure messaging: pwdavis@direct.nshcorp.org

Organizations & group practices 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1467462887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 196276",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995196276",
            "telephone_number": "907-565-6522",
            "fax_number": "907-565-6592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E 36TH AVE",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084372",
            "telephone_number": "907-562-9229",
            "fax_number": "907-562-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "PAUL",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "2541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD2541",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.