Shari M Davis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085001968 Issued in IL

Practice address

9718 S. Halsted
Chicago, IL 60628

Phone

(773) 233-4100

Fax

(773) 233-8542

NPI assigned

Sep 6, 2006

Last updated

Apr 23, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Foundation for Emergency Services

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1467468280
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1477656379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9718 S HALSTED ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606281007",
            "telephone_number": "773-298-2056",
            "fax_number": "773-233-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9718 S. HALSTED",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60628",
            "telephone_number": "773-233-4100",
            "fax_number": "773-233-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHARI",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085001968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085001968",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renita Davis, CHW
• Richla Davis, LCPC
• Robin Davis, M.S.
• Sarah Davis, MD
• Shane Maxwell Davis, MD
• Shavon Davis, NP
• Tameka Davis, LCPC
• Tekira Davis
• Tenika Davis
• Teresa E Davis, M.D.

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2013; 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.