NPIMap

Individual provider Active NPI

Gregory J Davis, DO

  • Internal Medicine Physician
  • Cleveland, OH
National Provider Identifier
1609862291
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
34007492 Issued in OH
Practice address
11201 Shaker Blvd
Suite 240
Cleveland, OH 44104-3873
Phone
(440) 842-5555
Fax
(440) 842-5556
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 34007492D OH
Internal Medicine Physician 207R00000X 34007492 OH Primary

Addresses

Primary practice location

11201 Shaker Blvd
Suite 240
Cleveland, OH 44104-3873

Mailing address

11201 Shaker Blvd
Suite 240
Cleveland, OH 44104-3873
Phone (216) 791-0017

Other identifiers 1

IdentifierTypeStateIssuer
2249409MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040219000641 OH Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 8729973581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faith Medical Associates, IncGroup PAC ID 7315831898, 5 clinicians

Practice addresses (Care Compare)

11201 Shaker Blvd
Cleveland, OH 44104-3873
Phone (216) 791-0017

6731 Ridge Rd
Suite 203
Parma, OH 44129-5708
Phone (440) 842-5555

Hospital & facility affiliations

  • Continuum Care Hospice Hospice, Parma, OH, CCN 361644
  • Parma Community General Hospital Hospital, Parma, OH, CCN 360041
  • Southwest General Health Center Hospital, Middleburg Heights, OH, CCN 360155
  • Pleasantview Care Center Nursing home, Parma, OH, CCN 365084
  • Pleasant Lake Villa Nursing home, Parma, OH, CCN 365706

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34007492DOHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Medical Associates, Inc Internal Medicine CurrentSince Aug 1, 2001 Accepting new patients
University Manor Healthcare Group, Inc Past Accepting new patients
Ridge-Pleasant Valley, Inc. Past Accepting new patients
Parma Community General Hospital Association Past Accepting new patients

Locations

11201 Shaker Blvd
Ste 240
Cleveland, OH 44104
Phone (216) 359-3469

99 Northline Cir
Ste 99
Euclid, OH 44119
Phone (216) 692-3668

6731 Ridge Rd
Ste 203
Parma, OH 44129
Phone (216) 884-0700

464 Richmond Rd
Richmond Hts, OH 44143
Phone (216) 261-6398

Interoperability endpoints

  • Direct secure messaging: gdavis37653@ehrdirect.uhhospitals.org

Organizations & group practices 4

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353974400000",
    "number": "1609862291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 SHAKER BLVD",
            "address_2": "SUITE 240",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441043873",
            "telephone_number": "216-791-0017",
            "fax_number": "216-791-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 SHAKER BLVD",
            "address_2": "SUITE 240",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441043873",
            "telephone_number": "440-842-5555",
            "fax_number": "440-842-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GREGORY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2012-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34007492D",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34007492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2249409",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.