Richard Lee Davis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD032778E Issued in PA

Practice address

4470 Valley St
Enola, PA 17025-1443

Phone

(717) 732-8883

Fax

(717) 732-1640

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 18, 2009.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250553600000",
    "number": "1679533665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WALNUT ST",
            "address_2": "SUITE 206",
            "city": "LEMOYNE",
            "state": "PA",
            "postal_code": "170431168",
            "telephone_number": "717-761-0208",
            "fax_number": "717-761-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4470 VALLEY ST",
            "city": "ENOLA",
            "state": "PA",
            "postal_code": "170251443",
            "telephone_number": "717-732-8883",
            "fax_number": "717-732-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2009-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD032778E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068548",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cumberland Life LLC
• Renee Anne Cummings, OT
• Valerie M Cupp
• Lisa M Davis, MD
• Mitchell Robert Davis, O.D.
• Allison Mari Debroisse, DPT
• Nirut Desai
• Mary E Dixon, CRNP
• Sean Donegan, DPT
• Ryan Scott Donner, PA-C

• All providers in Enola, PA
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.