NPIMap

Individual provider Active NPI

Mitchell Gordon Davis, MD

  • Cardiovascular Disease Physician
  • Gainesville, GA
National Provider Identifier
1528047149
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
035030 Issued in GA
Practice address
200 S Enota Dr NE Ste 100
Gainesville, GA 30501-3466
Phone
(770) 534-2020
Fax
(770) 534-8025
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 035030 GA Primary

Addresses

Primary practice location

200 S Enota Dr NE Ste 100
Gainesville, GA 30501-3466

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other identifiers 1

IdentifierTypeStateIssuer
000480873MedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdavis29442@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20050301000057 GA Practitioner - Cardiovascular Disease (Cardiology) 3274591664 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Medical College of Georgia School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Heart Institute LLC 127 clinicians

Practice addresses (Care Compare)

200 S Enota Dr NE
Suite 100
Gainesville, GA 30501-3466
Phone (770) 534-2020

Hospital & facility affiliations

  • Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029
  • Northeast Georgia Medical Center Lumpkin Hospital, Dahlonega, GA, CCN 110237
  • Northeast Georgia Medical Center Habersham Hospital, Demorest, GA, CCN 110041
  • NGMC Barrow, LLC Hospital, Winder, GA, CCN 110045
  • Union General Hospital Hospital, Blairsville, GA, CCN 110051

Merit-based Incentive Payment System (MIPS)

Final score
88.46 of 100Reported as group
Quality
85.33
Promoting interoperability
100
Improvement activities
40
Cost
76.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035030GAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NGMC Barrow LLC CurrentSince May 6, 2022 Accepting new patients
Georgia Heart Institute LLC Cardiovascular Disease CurrentSince Jun 1, 2014 Accepting new patients
NGMC Lumpkin, LLC CurrentSince May 5, 2022 Accepting new patients

Locations

77 Weaver Rd
#B
Blairsville, GA 30512
Phone (706) 439-6165

1200 Northside Forsyth Dr
Cumming, GA 30041
Phone (770) 292-4806

227 Mountain Dr
Dahlonega, GA 30533
Phone (706) 864-6136

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

200 S Enota Dr NE
Ste 100
Gainesville, GA 30501
Phone (770) 219-0950

200 S Enota Dr NE
Ste 200
Gainesville, GA 30501
Phone (770) 534-0991

316 N Broad St
Winder, GA 30680
Phone (770) 307-5354

Interoperability endpoints

  • Direct secure messaging: mdavis29442@nghs.gadirect.net

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.

Hospital & facility affiliations 5

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1528047149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S ENOTA DR NE STE 100",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013466",
            "telephone_number": "770-534-2020",
            "fax_number": "770-534-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MITCHELL",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "035030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000480873",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdavis29442@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "200 S Enota Dr NE Ste 100",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.