NPIMap

Individual provider Active NPI

Benjamin Davis, MD

  • Family Medicine Physician
  • Rocky Mount, VA
National Provider Identifier
1508077611
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101243625 Issued in VA
Practice address
390 S Main St Ste 201
Rocky Mount, VA 24151-1767
Phone
(540) 484-4800
NPI assigned
May 24, 2007
Last updated
Jan 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 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 0116017177 VA
Family Medicine Physician 207Q00000X 0101243625 VA Primary

Addresses

Primary practice location

390 S Main St Ste 201
Rocky Mount, VA 24151-1767

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713
Phone (540) 224-5353

Other practice location 1

2145 Mount Pleasant Blvd SE
Roanoke, VA 24014-3632
Phone (540) 427-9200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20080811000676 VA Practitioner - Family Practice 5294809166 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Universal Health CorporationGroup PAC ID 5597912626, 120 clinicians

Practice addresses (Care Compare)

1945 Roanoke Blvd
Salem, VA 24153-6408
Phone (540) 345-3894

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101243625VAMDFamily Medicine Physician
0116017177VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pai Participant 1 LLC CurrentSince Aug 8, 2025 Accepting new patients
Universal Health Corporation CurrentSince Jun 9, 2025 Accepting new patients

Locations

1475 Virginia Ave
Harrisonburg, VA 22802
Phone (540) 564-3400

1945 Roanoke Blvd
Salem, VA 24153
Phone (540) 345-3094

Interoperability endpoints

  • Direct secure messaging: bdavis5560@direct.carilionclinic.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Heritage Hall- BlacksburgBlacksburg, VA, CCN 495356 Skilled nursing facility Adp of the SNF Mar 25, 2026

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1508077611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713",
            "telephone_number": "540-224-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 S MAIN ST STE 201",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "241511767",
            "telephone_number": "540-484-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2145 Mount Pleasant Blvd SE",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240143632",
            "country_code": "US",
            "telephone_number": "540-427-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116017177",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101243625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, VA

Sources for this page

Verify at the official NPI Registry.