Ivan Davis

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

ME124071 Issued in FL

Practice address

1601 S.W. Archer Road
Gainesville, FL 32608-1197

Phone

(352) 376-1611

NPI assigned

Aug 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Florida Clinical Practice Association Inc

  • Surgery Physician
  • Gainesville, FL
  • NPI 1063463768
  Medicare reassignment NPD
• Florida Clinical Practice Association Inc

  • Durable Medical Equipment & Medical Supplies
  • Ocala, FL
  • NPI 1609529478
  NPD

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1467645788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 S.W. ARCHER ROAD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 S.W. ARCHER ROAD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326081197",
            "telephone_number": "352-376-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "IVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-21",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101251873",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME124071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015001500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Desiree N Davis, PTA
• Elaine D. Davis, APRN
• Evan Davis
• Heather Nocal Davis, LMT
• Hugh Davis, MD
• James Lockhart Davis, L.C.S.W.
• Jeremy Davis, MD
• Jessica Davis
• Jonae A Davis
• Joshua Davis, MD

• Diagnostic Radiology Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.