Timothy Jordan Davis, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT-002825 Issued in AZ

Practice address

3900 W Ray Rd Ste 1
Chandler, AZ 85226-2412

Phone

(480) 820-9880

NPI assigned

Aug 14, 2024

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

Medicare fee-for-service enrollment

Enrolled in AZ

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

University of Houston - College of Optometry, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John H McDougall OD Arizona PCGroup PAC ID 3274880117, 44 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• John H McDougall OD Arizona PC

  • Optometrist
  • Fountain Hills, AZ
  • NPI 1851882179
  Medicare reassignment Care Compare group NPD
• Oasis Vision Center, P.C.

  • Optometrist
  • Gilbert, AZ
  • NPI 1275628919
  NPD (past)

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1659103240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W RAY RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262412",
            "telephone_number": "480-820-9880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4838 E Baseline Rd Ste 129",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852064673",
            "country_code": "US",
            "telephone_number": "480-892-6560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TIMOTHY",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Davis
• Lora Davis, PT, DPT, MS
• Nicole Davis, PTA
• Raven Davis
• Romona L. Davis, DDS
• Todd Davis, D.O.
• Colette Victoria Davison, B.S., M.ED, SLPA
• Sarah L. Davison, ACNP-BC
• Bennette Renee Dawson, ED.D.
• Gabrielle Dawson

• Optometrist in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.