NPIMap

Individual provider Active NPI

Cherrica T Davis, M.D.

  • Internal Medicine Physician
  • Willowick, OH
National Provider Identifier
1487677233
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-084193 Issued in OH
Practice address
29804 Lakeshore Boulevard
Willowick, OH 44095
Phone
(440) 833-2095
Fax
(440) 833-2096
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) Physician 207RA0401X 35-084193 OH
Pediatrics Physician 208000000X 35-084193 OH
Internal Medicine Physician 207R00000X 35-084193 OH Primary

Addresses

Primary practice location

29804 Lakeshore Boulevard
Willowick, OH 44095

Mailing address

PO Box 781389
Detroit, MI 48278-1389
Phone (440) 953-6082

Other identifiers 1

IdentifierTypeStateIssuer
2668206MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cherrica.davis@lhpg.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060907000516 OH Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4284638198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Wayne State University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lake Hospital System, Inc.Group PAC ID 6002713922, 92 clinicians

Practice addresses (Care Compare)

11100 Euclid Ave
Cleveland, OH 44106-1716

29804 Lake Shore Blvd
Willowick, OH 44095-4611
Phone (440) 833-2095

36500 Euclid Ave
Willoughby, OH 44094-4455
Phone (440) 516-0530

Hospital & facility affiliations

  • Lake Health Hospital, Concord, OH, CCN 360098
  • Uh Cleveland Medical Center Hospital, Cleveland, OH, CCN 360137

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-084193OHMDAddiction Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Hospital System, Inc Internal Medicine CurrentSince May 23, 2007 Accepting new patients
Lake Hospital System Inc Internal Medicine Current Accepting new patients
Lake Hospital System Inc CurrentSince May 23, 2007 Accepting new patients
Lake Hospital System, Inc Internal Medicine Past Accepting new patients
Lake Hospital System Past Accepting new patients
Lake Hospital System Inc. Past Accepting new patients
Lake Hospital System Inc Past Accepting new patients

Locations

510 5th Ave
Chardon, OH 44024
Phone (440) 285-9494

6270 N Ridge Rd
Madison, OH 44057
Phone (440) 428-8292

10780 Kinsman Rd
Newbury, OH 44065
Phone (440) 564-5656

29804 Lake Shore Blvd
Willowick, OH 44095
Phone (440) 585-3322

30498 Lake Shore Blvd
Willowick, OH 44095
Phone (440) 585-3322

Interoperability endpoints

  • Direct secure messaging: cdavispulley37613@ehrdirect.uhhospitals.org

Organizations & group practices 8

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1487677233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781389",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781389",
            "telephone_number": "440-953-6082",
            "fax_number": "440-953-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29804 LAKESHORE BOULEVARD",
            "city": "WILLOWICK",
            "state": "OH",
            "postal_code": "44095",
            "telephone_number": "440-833-2095",
            "fax_number": "440-833-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHERRICA",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "OH",
            "license": "35-084193",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35-084193",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-084193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2668206",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cherrica.davis@lhpg.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Baseline West Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "29804 Lakeshore Boulevard",
            "city": "Willowick",
            "state": "OH",
            "country_code": "US",
            "postal_code": "44095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Willowick, OH

Sources for this page

Verify at the official NPI Registry.