Active NPI
Brian Mark Davis, P.A.
- Medical Physician Assistant
- Redding, CA
National Provider Identifier
1508946351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA 18631
- Practice address
- 2510 Airpark Dr Ste 301
Redding, CA 96001-2462 - Phone
- (530) 242-3500
- Fax
- (530) 242-3546
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA 18631 | CA | Primary |
Addresses
Primary practice location
2510 Airpark Dr Ste 301
Redding, CA 96001-2462
Mailing address
3400 Data Dr
Attn Credentialing/Payer Enrollment
Rancho Cordova, CA 95670-7956
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: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070330000531 | CA | Practitioner - Physician Assistant | 3072617059 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dignity Health Medical Foundation
Practice addresses (Care Compare)
2510 Airpark Dr
Suite 301
Redding, CA 96001-2462
Phone (530) 242-3500
2624 Edith Ave
Redding, CA 96001-3043
Phone (530) 806-1190
Hospital & facility affiliations
- Mercy Medical Center Redding
- St Elizabeth Community Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.64 of 100
- Quality
- 86.27
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18631 | CA | MD | Occupational Therapist |
| PA 18631 | CA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apogee Outpatient Surgery Center | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Catholic Healthcare West | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients |
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 and National Provider Directory roles.
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- Ambulatory Surgical Clinic/Center
- Redding, CA
- NPI 1912094509
-
- Institutional Pharmacy
- Red Bluff, CA
- NPI 1265472914
-
- Skilled Nursing Facility
- Mount Shasta, CA
- NPI 1376535344
-
- General Acute Care Hospital
- Redding, CA
- NPI 1477671535
Hospital & facility affiliations 3
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": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572393600000",
"number": "1508946351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 DATA DR",
"address_2": "ATTN CREDENTIALING/PAYER ENROLLMENT",
"city": "RANCHO CORDOVA",
"state": "CA",
"postal_code": "956707956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2510 AIRPARK DR STE 301",
"city": "REDDING",
"state": "CA",
"postal_code": "960012462",
"telephone_number": "530-242-3500",
"fax_number": "530-242-3546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "BRIAN",
"middle_name": "MARK",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2019-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA 18631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; 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.