Demetria Leonard Davis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1876 Issued in TN

Practice address

6100 Primacy Pkwy
Suite 112
Memphis, TN 38119-0705

Phone

(901) 682-5335

Fax

(901) 682-5440

NPI assigned

Jul 21, 2005

Last updated

Aug 16, 2011By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christian Family Medicine, LLCGroup PAC ID 7315903978, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AHIIAA/Endpoint/AHIIAA

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.

• Christian Family Medicine, LLC

  dba Christian Family Medicine and Pediatrics

  • Family Medicine Physician
  • Ripley, TN
  • NPI 1043252620
  Medicare reassignment Care Compare group NPD
• American Current Care PA

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1184805574

  TN

  Medicare reassignment NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  TN

  Medicare reassignment
• American Current Care P.a.

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Beaumont, TX
  • NPI 1376356568
  NPD
• Memphis & Shelby County Ped. Group

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1710067020
  NPD (past)
• Memphis & Shelby County Pediatric Group

  • Pediatric Adolescent Medicine Physician
  • Memphis, TN
  • NPI 1487797536
  NPD (past)
• Wellness One Memphis PC

  • Sports Medicine (Family Medicine) Physician
  • Memphis, TN
  • NPI 1124497730
  NPD (past)

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1699774539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 PRIMACY PKWY",
            "address_2": "SUITE 112",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190705",
            "telephone_number": "901-682-5335",
            "fax_number": "901-682-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 PRIMACY PKWY",
            "address_2": "SUITE 112",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190705",
            "telephone_number": "901-682-5335",
            "fax_number": "901-682-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DEMETRIA",
        "middle_name": "LEONARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA1876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522983",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clarence Davis Jr., M.D.
• Clay Michael Davis, M.A.
• Courtney G Davis, CRNA
• Cynthia Lynn Davis, MS PT
• Deborah L Davis, MS, RD, LDN
• Denitra Davis, M.ED., MHP
• Donna Davis
• Edward R Davis, MD
• Erma Louise Davis, FNP-BC, CWS
• Hollye Carson Davis, RN, BSN

• Physician Assistant in Memphis, TN
• Providers in Memphis, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; 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.