Individual provider Active NPI

Gregory Lynn Davis, M.D.

  • Gynecology Physician
  • Chico, CA
National Provider Identifier
1497752877
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
G73638 Issued in CA
Practice address
1040 Mangrove Ave
Chico, CA 95926-3509
Phone
(530) 345-0064
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X G73638 CA Primary

Addresses

Primary practice location

1040 Mangrove Ave
Chico, CA 95926-3509

Mailing address

1040 Mangrove Ave
Chico, CA 95926-3509
Phone (530) 345-0064

Other identifiers 1

IdentifierTypeStateIssuer
00G736380MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240430001988 GA Practitioner - Obstetrics/Gynecology 4183677537 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Loma Linda University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Effingham Hospital IncGroup PAC ID 1254628092, 14 clinicians

Practice addresses (Care Compare)

110 Goshen Rd
Rincon, GA 31326-5744
Phone (912) 826-5239

Hospital & facility affiliations

  • Effingham Health System Hospital, Springfield, GA, CCN 111306

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73638CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Effingham Hospital, Inc. CurrentSince Mar 24, 2024 Accepting new patients
Effingham Hospital, Inc. CurrentSince Mar 24, 2024 Accepting new patients
Effingham Hospital, Inc. Current Accepting new patients
Effingham Hospital, Inc. Past Accepting new patients
Effingham Hospital, Inc. Past Accepting new patients
Effingham Hospital, Inc. Past Accepting new patients

Locations

3 Hidden Creek Dr
Guyton, GA 31312
Phone (912) 772-8620

7306 State Highway 21
Ste 105
Port Wentworth, GA 31407
Phone (912) 826-1500

100 Goshen Rd
Rincon, GA 31326
Phone (912) 826-6000

110 Goshen Rd
Rincon, GA 31326
Phone (912) 826-1400

1451 Highway 21 S
Ste H
Springfield, GA 31329
Phone (912) 754-1035

459 Highway 119 S
Springfield, GA 31329
Phone (912) 754-0200

Organizations & group practices 6

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 1

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1497752877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 MANGROVE AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959263509",
            "telephone_number": "530-345-0064",
            "fax_number": "530-345-0680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 MANGROVE AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959263509",
            "telephone_number": "530-345-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GREGORY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "G73638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G736380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.