Active NPI
Justin Chesed Kuttner Davis, M.D.
- Family Medicine Physician
- Gainesville, FL
National Provider Identifier
1497813745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME88108
- Practice address
- 322 SW 4TH Ave
Gainesville, FL 32601-6550 - Phone
- (352) 641-0123
- Fax
- (415) 872-0560
- NPI assigned
- Dec 5, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A91502 | CA | |
| Family Medicine Physician | 207Q00000X | ME88108 | FL | Primary |
Addresses
Primary practice location
322 SW 4TH Ave
Gainesville, FL 32601-6550
Mailing address
322 SW 4TH Ave
Gainesville, FL 32601-6550
Phone (352) 641-0123
Other practice location 1
4132 3rd St Unit 7
San Francisco, CA 94124-2175
Phone (415) 994-9455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140517000100 | CA | Order and Referring Only - Family Practice | 5193791275 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 91502 | CA | MD | Pharmacist |
| A91502 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761091200000",
"number": "1497813745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "322 SW 4TH AVE",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326016550",
"telephone_number": "352-641-0123",
"fax_number": "415-872-0560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 SW 4TH AVE",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326016550",
"telephone_number": "352-641-0123",
"fax_number": "415-872-0560"
}
],
"practiceLocations": [
{
"address_1": "4132 3rd St Unit 7",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941242175",
"country_code": "US",
"telephone_number": "415-994-9455",
"fax_number": "415-872-0560",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "JUSTIN",
"middle_name": "CHESED KUTTNER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2025-10-22",
"certification_date": "2025-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A91502",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME88108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.