Active NPI
Johnathon Dewayne Davis, DO
- Contractor
- Brentwood, TN
National Provider Identifier
1497445449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 14005
- Practice address
- 1001 Health Park Dr
Brentwood, TN 37027-5721 - Phone
- (615) 762-0529
- NPI assigned
- May 12, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 14005 | TN | Primary |
Addresses
Primary practice location
1001 Health Park Dr
Brentwood, TN 37027-5721
Mailing address
600 Heritage Dr Apt 288
Madison, TN 37115-6025
Phone (615) 762-0529
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14005 | TN | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683849600000",
"number": "1497445449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 HERITAGE DR APT 288",
"city": "MADISON",
"state": "TN",
"postal_code": "371156025",
"telephone_number": "615-762-0529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 HEALTH PARK DR",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370275721",
"telephone_number": "615-762-0529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JOHNATHON",
"middle_name": "DEWAYNE",
"name_prefix": "Mr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-12",
"last_updated": "2023-05-12",
"certification_date": "2023-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "TN",
"license": "14005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.