Individual provider Active NPI

Daron G Davis, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Lexington, KY
National Provider Identifier
1639139215
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
22701 Issued in KY
Practice address
290 Big Run Rd
Lexington, KY 40503-2903
Phone
(859) 685-0600
Fax
(859) 260-1003
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuropathology Physician 207ZN0500X 22701 KY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 22701 KY Primary

Addresses

Primary practice location

290 Big Run Rd
Lexington, KY 40503-2903

Mailing address

290 Big Run Rd
Lexington, KY 40503-2903
Phone (859) 685-0600

Other identifiers 1

IdentifierTypeStateIssuer
64227010MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22701KYMDNeuropathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1639139215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 BIG RUN RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032903",
            "telephone_number": "859-685-0600",
            "fax_number": "859-260-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 BIG RUN RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405032903",
            "telephone_number": "859-685-0600",
            "fax_number": "859-260-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DARON",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZN0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Neuropathology",
            "state": "KY",
            "license": "22701",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "22701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64227010",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.