Active NPI
Joel Tom Davis
- Surgery Physician
- Madison Heights, MI
National Provider Identifier
1487358487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 5151016352
- Practice address
- 27351 Dequindre Rd
Madison Heights, MI 48071-3487 - Phone
- (248) 967-7123
- NPI assigned
- Mar 27, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 5151016352 | MI | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
27351 Dequindre Rd
Madison Heights, MI 48071-3487
Mailing address
27351 Dequindre Rd
Madison Heights, MI 48071-3487
Phone (248) 967-7123
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5151016352 | MI | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685404800000",
"number": "1487358487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27351 DEQUINDRE RD",
"city": "MADISON HEIGHTS",
"state": "MI",
"postal_code": "480713487",
"telephone_number": "248-967-7123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27351 DEQUINDRE RD",
"city": "MADISON HEIGHTS",
"state": "MI",
"postal_code": "480713487",
"telephone_number": "248-967-7123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JOEL",
"middle_name": "TOM",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-27",
"last_updated": "2023-05-30",
"certification_date": "2023-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "5151016352",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.