NPIMap

Individual provider Active NPI

Nathan Graham Davis, PA-C

  • Family Medicine Physician
  • Wade, NC
National Provider Identifier
1609631829
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0010-13995 Issued in NC
Practice address
7118 Main St
Wade, NC 28395-9749
Phone
(910) 483-6694
NPI assigned
Feb 16, 2024
Last updated
Feb 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0010-13995 NC Primary

Addresses

Primary practice location

7118 Main St
Wade, NC 28395-9749

Mailing address

7118 Main St
Wade, NC 28395-9749
Phone (910) 483-6694

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240520002746 NC Practitioner - Physician Assistant 7214379437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7118 Main St
Wade, NC 28395-9749
Phone 91048366947057

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stedman-Wade Health Services, Inc. CurrentSince Mar 13, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nathan.davis.1@7912.direct.athenahealth.com

Organizations & group practices 2

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1609631829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7118 MAIN ST",
            "city": "WADE",
            "state": "NC",
            "postal_code": "283959749",
            "telephone_number": "910-483-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7118 MAIN ST",
            "city": "WADE",
            "state": "NC",
            "postal_code": "283959749",
            "telephone_number": "910-483-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "NATHAN",
        "middle_name": "GRAHAM",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "0010-13995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wade, NC

Sources for this page

Verify at the official NPI Registry.