NPIMap

Individual provider Active NPI

Elizabeth Mary Davis, MD

  • Internal Medicine Physician
  • Minneapolis, MN
National Provider Identifier
1558858761
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
67352 Issued in MN
Practice address
420 Delaware Street SE
MMC 284
Minneapolis, MN 55455
Phone
(612) 626-5454
NPI assigned
Apr 13, 2018
Last updated
Mar 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 67352 MN Primary

Addresses

Primary practice location

420 Delaware Street SE
MMC 284
Minneapolis, MN 55455

Mailing address

420 Delaware Street SE
MMC 284
Minneapolis, MN 55455
Phone (612) 626-5454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20210617001026 MN Practitioner - Internal Medicine 6002160231 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Minnesota Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians

Practice addresses (Care Compare)

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 273-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.44 of 100Reported as group
Quality
82.65
Promoting interoperability
100
Improvement activities
40
Cost
77.21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29319MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Single Specialty Current Accepting new patients
Fairview Express Care Single Specialty Current Accepting new patients
Fairview Clinics CurrentSince Jul 1, 2021 Accepting new patients
Healtheast Medical Research Institute Single Specialty CurrentSince Jan 1, 2023 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2023 Accepting new patients
Healtheast Medical Research Insititue CurrentSince Jan 1, 2023 Accepting new patients
Healtheast Medical Research Institute Single Specialty Current Accepting new patients
Fairview Health Services CurrentSince Jul 1, 2021 Accepting new patients
Fairview Express Care Single Specialty CurrentSince Jan 1, 2023 Accepting new patients

Locations

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

420 Delaware St SE
Ste MMC284
Minneapolis, MN 55455
Phone (612) 625-5454

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

Interoperability endpoints

  • Direct secure messaging: edavis324817@fairview.direct-ci.com

Organizations & group practices 10

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": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1558858761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE STREET SE",
            "address_2": "MMC 284",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-626-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DELAWARE STREET SE",
            "address_2": "MMC 284",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55455",
            "telephone_number": "612-626-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ELIZABETH",
        "middle_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "67352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.