Pamela B Davis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA0000001328 Issued in TN

Practice address

1627 Old Gray Station Rd
Ste 4
Johnson City, TN 37615-4193

Phone

(423) 282-3376

Fax

(423) 791-8388

NPI assigned

Aug 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Outreach Clinics Unlimited PLLCGroup PAC ID 5395092936, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Outreach Clinics Unlimited PLLC

  • Dermatology Physician
  • Johnson City, TN
  • NPI 1467968859
  Medicare reassignment Care Compare group
• Lawrence H Reid MD PC

  • Dermatology Physician
  • Greeneville, TN
  • NPI 1477624336
  NPD (past)
• Skinwise PLLC

  • Dermatology Physician
  • Johnson City, TN
  • NPI 1538025135
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1508877416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1627 OLD GRAY STATION RD",
            "address_2": "STE 4",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154193",
            "telephone_number": "423-282-3376",
            "fax_number": "423-791-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 OLD GRAY STATION RD",
            "address_2": "STE 4",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154193",
            "telephone_number": "423-282-3376",
            "fax_number": "423-791-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "PAMELA",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "PA0000001328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q037847",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Bradley Davis, LPC-MHSP
• Kayla Davis, PHARMD.
• Lindsey Leigh Davis, RDN, LDN
• Macy Davis
• Nakeia Chyanne Davis, DO
• Penny Elaine Davis, BSW
• Rachael Davis
• Shaylie Davis, APRN
• Tyler Davis, DDS
• Whitney Diane Davis, PA-C

• Medical Physician Assistant in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.