Individual provider Active NPI

Dallin Davies

  • Surgical Physician Assistant
  • Grand Junction, CO
National Provider Identifier
1669915088
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
2440 N 11TH St
Grand Junction, CO 81501-8102
Phone
(970) 243-0900
Fax
(970) 245-4235
NPI assigned
Dec 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

2440 N 11TH St
Grand Junction, CO 81501-8102

Mailing address

2440 N 11TH St
Grand Junction, CO 81501-8102
Phone (970) 243-0900

Other practice location 1

501 Airport Rd
Rifle, CO 81650-8510
Phone (970) 625-1510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20170130001035 CO Practitioner - Physician Assistant 6305128273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Colorado Surgical Affiliates LLCGroup PAC ID 5496034068, 52 clinicians

Practice addresses (Care Compare)

2440 N 11St St
Grand Junction, CO 81501-8102
Phone (970) 243-0900

Hospital & facility affiliations

  • Intermountain Health St. Mary'S Regional Hospital Hospital, Grand Junction, CO, CCN 060023
  • Family Health West Hospital Hospital, Fruita, CO, CCN 061302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Surgical Affiliates, LLC CurrentSince Jan 1, 2017 Accepting new patients

Locations

2440 N 11th St
Grand Junction, CO 81501
Phone (970) 243-0900

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

Interoperability endpoints

  • Direct secure messaging: dallindavies@gswc.allscriptsdirect.net

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1480723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1669915088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 N 11TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018102",
            "telephone_number": "970-243-0900",
            "fax_number": "970-245-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 N 11TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018102",
            "telephone_number": "970-243-0900",
            "fax_number": "970-245-4235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Airport Rd",
            "address_purpose": "LOCATION",
            "city": "Rifle",
            "state": "CO",
            "postal_code": "816508510",
            "country_code": "US",
            "telephone_number": "970-625-1510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "DALLIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-03",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.