Active NPI
Michael A Davis, MD
- Pediatrics Physician
- Santa Rosa, CA
National Provider Identifier
1477709723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- C309360
- Practice address
- 575 Los Alamos Rd
Santa Rosa, CA 95409-4430 - Phone
- (707) 539-7008
- Fax
- (707) 439-0178
- NPI assigned
- Aug 18, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C309360 | CA | Primary |
Addresses
Primary practice location
575 Los Alamos Rd
Santa Rosa, CA 95409-4430
Mailing address
575 Los Alamos Rd
Santa Rosa, CA 95409-4430
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C309360 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219017600000",
"number": "1477709723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "575 LOS ALAMOS RD",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954094430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "575 LOS ALAMOS RD",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954094430",
"telephone_number": "707-539-7008",
"fax_number": "707-439-0178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MICHAEL",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-08-18",
"last_updated": "2008-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "C309360",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.