Brian R Davis, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

172302-1205 Issued in UT

Practice address

1325 W South Jordan Pkwy
Suite 103
South Jordan, UT 84095-9060

Phone

(801) 253-3080

Fax

(801) 253-0772

NPI assigned

Aug 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Saint Louis University School of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Davis Vision Center Associates PLLCGroup PAC ID 0446388805, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Davis Vision Center Associates PLLC

  dba Davis Vision Center

  • Ophthalmology Physician
  • South Jordan, UT
  • NPI 1689997165
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1679583470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 W SOUTH JORDAN PKWY",
            "address_2": "SUITE 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840959060",
            "telephone_number": "801-952-9500",
            "fax_number": "801-352-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 W SOUTH JORDAN PKWY",
            "address_2": "SUITE 103",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840959060",
            "telephone_number": "801-253-3080",
            "fax_number": "801-253-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRIAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "UT",
            "license": "172302-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID LICENSE NUMBER",
            "identifier": "D0565",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMD GROUP",
            "identifier": "DH0042",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180043150",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679583470",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jarrod Davies, O.D.
• Ariadna Davila
• Davis Orthodontics PLLC
• Davis Vision Center
• Davis Vision Center Associates PLLC (Davis Vision Center)
• Lauren Davis, TRAINED SBD DOULA
• Natalie Davis
• Ryan Davis, DDS
• Daybreak PDC PLLC (Platinum Dental Care)
• Mari Dean-Smith, DNP

• Ophthalmology Physician in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Ophthalmology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.