George Vestal Davis, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

17855 Issued in MS

Practice address

3407 Shamrock CT
Gautier, MS 39553-5337

Phone

(228) 497-0690

Fax

(228) 497-1363

NPI assigned

Jul 23, 2008

Last updated

Jul 23, 2008By 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 1

Medicare fee-for-service enrollment

Enrolled in MS

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

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.

• Singing River Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gautier, MS
  • NPI 1851407829
  Medicare reassignment

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216771200000",
    "number": "1700041308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 SHAMROCK CT",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535337",
            "telephone_number": "228-497-0690",
            "fax_number": "228-497-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 SHAMROCK CT",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535337",
            "telephone_number": "228-497-0690",
            "fax_number": "228-497-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GEORGE",
        "middle_name": "VESTAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-23",
        "last_updated": "2008-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "17855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00018214",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra J Curry
• Brian Keith Daniels, AASI BS
• Deanna Faye Danley
• David W Bonderer DDS PLLC
• Constance Yvonne Davis, AA
• Jamilla Melissa Davis, BA
• Savannah Ashley Davis
• Tamika Davis, RN
• Rebecca Day, MS
• Taylor Elizabeth Dehaven, DMD

• Psychiatry Physician in Gautier, MS
• Providers in Gautier, MS by specialty
• Psychiatry Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; 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.