David Samuel Davis, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

NV245 Issued in NV

Practice address

4840 E Bonanza Rd
Unit 6
Las Vegas, NV 89110-3453

Phone

(702) 385-7331

Fax

(702) 385-5431

NPI assigned

Jun 27, 2005

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 2

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

David S Davis OD PCGroup PAC ID 6204815822, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.davis@direct.revolutionehr.com

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.

• David S Davis OD PC

  • Optometrist
  • Las Vegas, NV
  • NPI 1306964382
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231804800000",
    "number": "1649276312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 E BONANZA RD",
            "address_2": "UNIT 6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891103453",
            "telephone_number": "702-385-7331",
            "fax_number": "702-385-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 E BONANZA RD",
            "address_2": "UNIT 6",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891103453",
            "telephone_number": "702-385-7331",
            "fax_number": "702-385-5431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DAVID",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2009-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "NV245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410049343",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002502022",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cristina Bartolome Davis
• Daniel Davis
• Darcy Louis Davis
• Dashawnna Marie Davis
• David J. Davis, M.D.
• Davrin Davis, RN
• Daysianae D Davis, RN
• Dayton Davis
• De'Imani Davis
• Deborah Davis

• Optometrist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2009; 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.