Organization Active NPI

Donen Davis Plastic Surgery, LLC

  • Plastic Surgery Physician
  • Columbia, SC
National Provider Identifier
1699953331
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
21726 Issued in SC
Legal business name
DONEN DAVIS PLASTIC SURGERY, LLC
Practice address
1850 Laurel St
Suite B
Columbia, SC 29201-2627
Phone
(803) 929-1901
Fax
(803) 929-1916
NPI assigned
Feb 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Authorized official

Name
Dr. Donen Davis, M.D.NPI 1972509925
Title
Owner
Phone
(803) 929-1901

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208200000X 21726 SC Primary

Addresses

Primary practice location

1850 Laurel St
Suite B
Columbia, SC 29201-2627

Mailing address

1850 Laurel St
Suite B
Columbia, SC 29201-2627
Phone (803) 929-1901

Other identifiers 1

IdentifierTypeStateIssuer
H575067949OtherSCMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040610000500 SC Part B Supplier - Clinic/Group Practice 5991788028 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Locations

100 Palmetto Health Pkwy
Ste 108
Columbia, SC 29212
Phone (803) 407-4940

1850 Laurel St
Ste B
Columbia, SC 29201
Phone (803) 929-1901

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349913600000",
    "number": "1699953331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 LAUREL ST",
            "address_2": "SUITE B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012627",
            "telephone_number": "803-929-1901",
            "fax_number": "803-929-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 LAUREL ST",
            "address_2": "SUITE B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012627",
            "telephone_number": "803-929-1901",
            "fax_number": "803-929-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONEN DAVIS PLASTIC SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2012-10-11",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DONEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-929-1901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "SC",
            "license": "21726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "H575067949",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.