Jacqueline Karen Davis, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

35-078520 Issued in OH

Practice address

200 Saint Clair Ave
Saint Marys, OH 45885-2400

Phone

(419) 394-3335

Fax

(419) 394-8485

NPI assigned

Jun 15, 2006

Last updated

Oct 22, 2014By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Geisel School of Medicine at Dartmouth, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wynn Hospital Hospital, Utica, NY, CCN 330044

Merit-based Incentive Payment System (MIPS)

Final score

85.28 of 100Reported as group

Quality

75.06

Promoting interoperability

100

Improvement activities

40

Cost

69.26

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdavis27754@mvhealthsystem.direct-ci.com

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.

• MVHS Inc

  dba Mohawk Valley Health System Inc

  • Family Medicine Physician
  • Utica, NY
  • NPI 1770690737
  Medicare reassignment Care Compare group NPD
• Oswego Hospital

  • General Acute Care Hospital
  • Oswego, NY
  • NPI 1871678458
  Medicare reassignment NPD
• MVHS Inc

  dba Mohawk Valley Health System Inc

  • Community/Retail Pharmacy
  • Utica, NY
  • NPI 1306573753
  NPD
• Oswego Hospital

  • Anesthesiology Physician
  • Oswego, NY
  • NPI 1255639043
  NPD
• Bedford Anesthesiologists and Pain Management

  • Pain Medicine (Anesthesiology) Physician
  • Bedford, OH
  • NPI 1275566978
  NPD (past)
• Consultants in Anesthesiology, Inc

  • Anesthesiology Physician
  • Greenville, OH
  • NPI 1275573925
  NPD (past)
• Fairfield Anesthesia Consultants Inc

  • Anesthesiology Physician
  • Fairfield, OH
  • NPI 1871775387
  NPD (past)
• JTDM Family Practice LLC

  • Family Medicine Physician
  • Saint Marys, OH
  • NPI 1184652539
  NPD (past)
• Uhhs Bedford

  • Internal Medicine Physician
  • Bedford, OH
  • NPI 1811933419
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• MVHS Inc

  dba Wynn Hospital

  • General Acute Care Hospital
  • Utica, NY
  • NPI 1205877172
  Care Compare affiliation

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1588608996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 N FRONT ST",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458851624",
            "telephone_number": "419-733-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SAINT CLAIR AVE",
            "city": "SAINT MARYS",
            "state": "OH",
            "postal_code": "458852400",
            "telephone_number": "419-394-3335",
            "fax_number": "419-394-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JACQUELINE",
        "middle_name": "KAREN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35-078520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2292915",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "7404631",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Compton, D.C.
• Margene Rose Craft
• Ronald Craft
• Fred A Culver, MT
• Laura Ann Koch Cunningham, RPH
• Stacey Dickman
• Dimensional Wellness LLC
• Susan Rose Donnal, PTA. 03450
• Melody Donovan
• Douglas Wine Family Optometry, Inc.

• Anesthesiology Physician in Saint Marys, OH
• Providers in Saint Marys, OH by specialty
• Anesthesiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.