Lisa Michelle Davis, PHD, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C0002863 Issued in MD

Practice address

3950 White Rose Way
Ellicott City, MD 21042-5822

Phone

(443) 865-5342

NPI assigned

Jan 6, 2025

Last updated

Jan 6, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maryland Family Care IncGroup PAC ID 5092629394, 157 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant, Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: ldavis110450@direct.mdmercy.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.

• Maryland Family Care, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1598718256
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1736121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1629887518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 WHITE ROSE WAY",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210425822",
            "telephone_number": "443-865-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 WHITE ROSE WAY",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210425822",
            "telephone_number": "443-865-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LISA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PHD, PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-06",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0002863",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "C0002863",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle David, PTA
• Risa Lynne Davis-Ganel, LCMFT
• Carmen Miles Davis, LCSW-C
• Celia M. Davis
• Christina Dawn Davis, RMP
• Michelle Davis
• Patricia Shields Davis
• Austin Day
• Stanley Chester Day III, P.T.
• Aileen Grace Fortich De Guzman, OTR

• Medical Physician Assistant in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.