NPIMap

Individual provider Active NPI

Jeffrey D Davis, DO

  • Family Medicine Physician
  • Memphis, MO
National Provider Identifier
1679558589
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2001023603 Issued in MO
Practice address
RR 1 Box 55
Sigler Ave.
Memphis, MO 63555-9726
Phone
(660) 465-7037
Fax
(660) 465-7350
NPI assigned
Dec 13, 2005
Last updated
Jul 12, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2001023603 MO Primary

Addresses

Primary practice location

RR 1 Box 55
Sigler Ave.
Memphis, MO 63555-9726

Mailing address

314 E McPherson St
Kirksville, MO 63501-3557
Phone (660) 627-5757

Other identifiers 1

IdentifierTypeStateIssuer
208313106MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100317000774 MO Practitioner - Family Practice 9335274240 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scotland County Memorial HospitalGroup PAC ID 8224940366, shared by 6 NPIs, 32 clinicians

Practice addresses (Care Compare)

450 E Sigler Ave
Suite a
Memphis, MO 63555-1726
Phone (660) 465-2828

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2001023603MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scotland County Memorial Hospital CurrentSince Nov 16, 2025 Accepting new patients
Scotland County Memorial Hospital Family Medicine Current Accepting new patients
Scotland County Memorial Hospital Family Medicine CurrentSince Sep 4, 2010 Accepting new patients
Scotland County Memorial Hospital Family Medicine CurrentSince Sep 4, 2010 Accepting new patients
Northeast Missouri Health Council Inc Past Accepting new patients
Clark County Nursing Home Past Accepting new patients
Northeast Missouri Health Council, Inc. Family Medicine Past Accepting new patients
Knox County Nursing Home District Past Accepting new patients
Pkanesthesia, Inc Past Accepting new patients
Scotland County Memorial Hosptial Past Accepting new patients
Scotland County Memorial Hospital PastSince Jan 19, 2020 Accepting new patients

Locations

55682 State Highway 6
Ste A
Edina, MO 63537
Phone (660) 460-8140

450 E Sigler Ave
Memphis, MO 63555
Phone (660) 465-2828

450 E Sigler Ave
Ste A
Memphis, MO 63555
Phone (660) 465-2828

450 E Sigler Ave
Ste C
Memphis, MO 63555

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Clark County Nursing HomeKahoka, MO, CCN 265485 Skilled nursing facility Adp of the SNF Mar 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

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.

Hospital & facility affiliations 6

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1679558589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 E MCPHERSON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013557",
            "telephone_number": "660-627-5757",
            "fax_number": "660-627-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 55",
            "address_2": "SIGLER AVE.",
            "city": "MEMPHIS",
            "state": "MO",
            "postal_code": "635559726",
            "telephone_number": "660-465-7037",
            "fax_number": "660-465-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2001023603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208313106",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, MO

Sources for this page

Verify at the official NPI Registry.