NPIMap

Individual provider Active NPI

Jerry Heath Davis, PHARMD, CPP

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Burnsville, NC
National Provider Identifier
1699083436
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
700404 Issued in NC
Practice address
116 Seven Mile Ridge Rd
Burnsville, NC 28714-8509
Phone
(828) 675-4116
NPI assigned
Sep 15, 2010
Last updated
Oct 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17187 NC
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 700404 NC Primary

Addresses

Primary practice location

116 Seven Mile Ridge Rd
Burnsville, NC 28714-8509

Mailing address

116 Seven Mile Ridge Rd
Burnsville, NC 28714-8509
Phone (828) 675-4116

Other practice location 1

71 Blue Ridge Ln
Burnsville, NC 28714-7270
Phone (828) 682-8588

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
700404NCMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
17187NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ingles Markets Inc Past Accepting new patients
Mountain Community Health Partnership Incorporated Past Accepting new patients
Mountain Community Health Partnership Incorporated Past Accepting new patients
Mountain Community Health Partnership Incorporated Past Accepting new patients
Mountain Community Health Partnership Incorporated Past Accepting new patients
Ingles Markets Inc PastSince Mar 27, 2022 Accepting new patients
Mountain Community Health Partnership Incorporated Past Accepting new patients

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1699083436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 SEVEN MILE RIDGE RD",
            "city": "BURNSVILLE",
            "state": "NC",
            "postal_code": "287148509",
            "telephone_number": "828-675-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 SEVEN MILE RIDGE RD",
            "city": "BURNSVILLE",
            "state": "NC",
            "postal_code": "287148509",
            "telephone_number": "828-675-4116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "71 Blue Ridge Ln",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "NC",
            "postal_code": "287147270",
            "country_code": "US",
            "telephone_number": "828-682-8588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JERRY",
        "middle_name": "HEATH",
        "name_prefix": "Dr.",
        "credential": "PHARMD, CPP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-15",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "17187",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NC",
            "license": "700404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.