Individual provider Active NPI

Justin Chesed Kuttner Davis, M.D.

  • Family Medicine Physician
  • Gainesville, FL
National Provider Identifier
1497813745
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME88108 Issued in FL
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

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140517000100 CA Order and Referring Only - Family PracticePractitioner - Family Practice 5193791275

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
91502CAMDPharmacist
A91502CAMDFamily 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

Verify at the official NPI Registry.