Trevor Lawton Davis, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9150 Issued in GA

Practice address

3301 N Oak Street Ext
Valdosta, GA 31605

Phone

(229) 242-6061

Fax

(229) 242-6151

NPI assigned

Mar 22, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Barry University School of Podiatric Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brian C. Griner, MD, LLCGroup PAC ID 8921190901, 4 clinicians

SGMC Affiliated Services LLCGroup PAC ID 5496284028, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SGMC Health Hospital, Valdosta, GA, CCN 110122
• SGMC Berrien Campus Hospital, Nashville, GA, CCN 110234
• SGMC Health Lanier Hospital, Lakeland, GA, CCN 111326

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Brian C. Griner, MD, LLC

  • Pediatrics Physician
  • Valdosta, GA
  • NPI 1083832901

  GA

  Medicare reassignment Care Compare group NPD
• SGMC Affiliated Services LLC

  • Multi-Specialty Clinic/Center
  • Valdosta, GA
  • NPI 1114740362

  GA

  Medicare reassignment Care Compare group NPD
• South Georgia Emergency Medicine Associates PC

  • Emergency Medicine Physician
  • Thomasville, GA
  • NPI 1386903649

  GA

  Medicare reassignment NPD

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

• South Georgia Medical Center Inc

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553

  Hospital

  Care Compare affiliation
• South Georgia Medical Center Inc

  • Critical Access Hospital
  • Lakeland, GA
  • NPI 1215703632

  Hospital

  Care Compare affiliation
• South Georgia Medical Center Inc

  • General Acute Care Hospital
  • Nashville, GA
  • NPI 1689440091

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1629538822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 N OAK STREET EXT",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31605",
            "telephone_number": "229-242-6061",
            "fax_number": "229-242-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 N OAK STREET EXT",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31605",
            "telephone_number": "229-242-6061",
            "fax_number": "229-242-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TREVOR",
        "middle_name": "LAWTON",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "051253600",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary E Davis, BCBA
• Porshia Davis
• Samira Y Davis, PH.D., LMFT
• Shelaine V Davis, CEO TRACKSS HOME CAR
• Stephanie Ann Davis, LPC
• Jasmine Loving Dawson, FNP-C
• Shakierra Dawson
• Steven Brian Dawson, M.D.
• Daniel Day
• Mary T Dazey, CNM

• All providers in Valdosta, GA
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; 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.