Michael A Davis, M.D

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD23820 Issued in OR

Practice address

840 Royal Ave
Suite 110
Medford, OR 97504-6461

Phone

(541) 732-8370

Fax

(541) 732-8371

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Providence Health & Services - Oregon

  dba Providence Medford Medical Center

  • Clinic/Center
  • Medford, OR
  • NPI 1093976243
  Medicare reassignment NPD
• Providence Health & Services Oregon

  dba Providence Medical Group South

  • Family Medicine Physician
  • Medford, OR
  • NPI 1568547503
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  dba Providence Medford Medical Center

  • Clinical Pathology Physician
  • Medford, OR
  • NPI 1285185942
  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group South

  • Clinic/Center
  • Phoenix, OR
  • NPI 1992882500
  NPD
• Providence Health & Services Oregon

  dba PMG South Medford Family Practice

  • Family Medicine Physician
  • Medford, OR
  • NPI 1386713972
  NPD

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1629150420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 ROYAL AVE",
            "address_2": "SUITE 110",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046461",
            "telephone_number": "541-732-8370",
            "fax_number": "541-732-8371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD23820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdavis140385@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "840 Royal Ave",
            "address_2": "Suite 110",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975046461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John T. Davis, PA-C
• Kevin Davis
• Laurie Davis, ORT
• Mark Jeffrey Davis, QMHA
• Marlon Davis
• Rhiannon Kristine Davis
• Robert Ash Davis, RN
• Talya Davis, RN
• Patrick Erin Davol, M.D.
• Erica Davoren

• Pediatrics Physician in Medford, OR
• Providers in Medford, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.