John Evan Davis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101031673 Issued in VA

Practice address

1 Clinic Dr
Richlands, VA 24641-1102

Phone

(276) 964-6771

Fax

(276) 964-1314

NPI assigned

Nov 4, 2005

Last updated

Feb 13, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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 VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4
• Direct secure messaging: john.davis@vab.hcadirect.net

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.

• Clinch Valley Physicians Associates LLC

  dba Clinch Valley Physicians

  • Cardiovascular Disease Physician
  • Richlands, VA
  • NPI 1104265214

  Pediatrics

  Medicare reassignment NPD
• Clinch Valley Physicians Associates LLC

  dba Clinch Valley Physicians

  • Rural Health Clinic/Center
  • Cedar Bluff, VA
  • NPI 1821339540
  NPD
• Clinch Valley Physicians Inc

  • Clinical Medical Laboratory
  • Richlands, VA
  • NPI 1669454781
  NPD (past)
• Clinch Valley Physicians Inc

  dba The Clinic

  • Multi-Specialty Clinic/Center
  • Richlands, VA
  • NPI 1912980855
  NPD (past)

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423785600000",
    "number": "1699766998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX CVPA",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "246411102",
            "telephone_number": "276-964-6771",
            "fax_number": "276-964-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CLINIC DR",
            "city": "RICHLANDS",
            "state": "VA",
            "postal_code": "246411102",
            "telephone_number": "276-964-6771",
            "fax_number": "276-964-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOHN",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2015-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101031673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64664568",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "002744",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6785808",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0107690-000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Community-Based Services LLC (The Diabetes Education Center)
• Logan Cook, FNP
• Thomas Brian Cortellesi, DO
• Nona Crouse, NP
• Tammy Jean Davidson, NURSE PRACTITIONER
• Debra J. Thomas, M.D., PC
• Roxanne M Decker, CRNA
• Diagnostic Imaging Associates
• Sierra Dunford
• Alice Elswick

• Pediatrics Physician in Richlands, VA
• Providers in Richlands, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.