Willie Bob Davis, ME

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

04-17213 Issued in KS

Practice address

20333 W 151St St
Olathe, KS 66061-5350

Phone

(913) 791-4408

Fax

(913) 791-4438

NPI assigned

Jun 15, 2005

Last updated

Apr 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Engineering

State licenses

Practice roles

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.

• Kansas City Imaging Center, LLC

  • Diagnostic Radiology Physician
  • Kansas City, KS
  • NPI 1518900992
  NPD (past)
• United Imaging Consultants, LLC

  • Diagnostic Radiology Physician
  • Lenexa, KS
  • NPI 1588669766
  NPD (past)

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1659376952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 FOXRIDGE DR",
            "address_2": "STE 240",
            "city": "MISSION",
            "state": "KS",
            "postal_code": "662022338",
            "telephone_number": "913-261-3153",
            "fax_number": "913-262-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20333 W 151ST ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660615350",
            "telephone_number": "913-791-4408",
            "fax_number": "913-791-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WILLIE",
        "middle_name": "BOB",
        "name_prefix": "Dr.",
        "credential": "ME",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "MO  R5059",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "KS 04-17213",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "R5059",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "KS",
            "license": "04-17213",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "KS",
            "license": "04-17213",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201018322",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10001780C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mishawn Davis
• Nanette D Davis
• Shonta Denise Davis
• Silvia E. Davis, PTA
• Tanya Davis, RN
• Chris C Davlantes, MD
• Michael P Davoren, M.D.
• Michael R Dawdy, MD
• Samantha Dawley
• Rebecca Day

• Diagnostic Radiology Physician in Olathe, KS
• Providers in Olathe, KS by specialty
• Diagnostic Radiology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.