Individual provider Active NPI

Brandon Michael Davis, DO

  • Family Medicine Physician
  • Athens, OH
National Provider Identifier
1689319659
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34.017990 Issued in OH
Practice address
2131 E State St
Athens, OH 45701-2138
Phone
(855) 446-5937
Fax
(844) 261-1517
NPI assigned
May 3, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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 34.017990 OH Primary

Addresses

Primary practice location

2131 E State St
Athens, OH 45701-2138

Mailing address

2131 E State St
Athens, OH 45701-2138
Phone (855) 446-5937

Other identifiers 1

IdentifierTypeStateIssuer
0135267MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brandon.davis1@17389.direct.athenahealth.com Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250801002125 OH Practitioner - Family Practice 2062894264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Liberty Univ College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holzer Clinic LLCGroup PAC ID 5890606008, 266 clinicians

Practice addresses (Care Compare)

2131 E State St
Athens, OH 45701-2138
Phone (740) 589-3100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
I Path LLC Current Accepting new patients
Holzer Clinic, LLC CurrentSince Jul 28, 2025 Accepting new patients

Locations

2131 E State St
Athens, OH 45701
Phone (740) 589-3100

100 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5050

90 Jackson Pike
Gallipolis, OH 45631
Phone (740) 446-5131

Interoperability endpoints

  • Direct secure messaging: brandon.davis.1@17389.direct.athenahealth.com
  • Direct secure messaging: brandon.davis1@17389.direct.athenahealth.com

Organizations & group practices 2

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 2

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": "1651536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1689319659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 E STATE ST",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012138",
            "telephone_number": "855-446-5937",
            "fax_number": "740-589-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 E STATE ST",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012138",
            "telephone_number": "855-446-5937",
            "fax_number": "844-261-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-03",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34.017990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0135267",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brandon.davis1@17389.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2131 E State St",
            "city": "Athens",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457012138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

Verify at the official NPI Registry.