Active NPI
Jeremiah Paul Davis, PA
- Physician Assistant
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-02638
- Practice address
- 1237 Harding PL
Ste 3100
Charlotte, NC 28204 - Phone
- (704) 373-0212
- NPI assigned
- Jun 21, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-02638 | NC | Primary |
Addresses
Primary practice location
1237 Harding PL
Ste 3100
Charlotte, NC 28204
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
10650 Park Rd
Charlotte, NC 28210-8538
Phone (704) 667-3840
Other practice location 2
1237 Harding Pl
Ste 4300
Charlotte, NC 28204
Phone (704) 373-0212
Other practice location 3
200 Medical Park Dr
Ste 230
Concord, NC 28025-2982
Phone (704) 403-1349
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jdavis631691@CarolinasHealthcareSystem.direct-ci.com | Atrium Health | |
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000
10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-1000
10648 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-7070
134 Medical Park Rd
Suite 111
Mooresville, NC 28117-8527
Phone (704) 801-9100
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 94 of 100
- Quality
- 81.63
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-02638 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Carolinas Physicians Network, Inc | Past | Accepting new patients |
Locations
100 N 6th St
Ste 900A
Minneapolis, MN 55403
10650 Park Rd
Charlotte, NC 28210
Phone (704) 667-0337
1237 Harding Pl
Ste 3100
Charlotte, NC 28204
1001 Blythe Blvd
Ste 300
Charlotte, NC 28203
1237 Harding Pl
Ste 4300
Charlotte, NC 28204
1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791
990 Lee Ann Dr NE
Concord, NC 28025
Phone (704) 441-0272
200 Medical Park Dr
Ste 230
Concord, NC 28025
Phone (704) 403-1349
134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100
Interoperability endpoints
- jdavis631691@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Charlotte, NC
- NPI 1477878890
-
- Internal Medicine Physician
- Shelby, NC
- NPI 1023440898
-
- Endocrinology, Diabetes & Metabolism Physician
- Charlotte, NC
- NPI 1437038544
-
- Family Medicine Physician
- Charlotte, NC
- NPI 1578939914
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Charlotte, NC
- NPI 1053358945
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1295789907
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1376985135
-
- Children's Rehabilitation Hospital
- Charlotte, NC
- NPI 1699829887
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Charlotte, NC
- NPI 1720029705
Hospital
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1417432840
-
- Rehabilitation Hospital Unit
- Charlotte, NC
- NPI 1962987131
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683763200000",
"number": "1700107018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19305",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282199305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1237 HARDING PL",
"address_2": "STE 3100",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28204",
"telephone_number": "704-373-0212"
}
],
"practiceLocations": [
{
"address_1": "10650 Park Rd",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282108538",
"country_code": "US",
"telephone_number": "704-667-3840",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1237 Harding Pl",
"address_2": "Ste 4300",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "28204",
"country_code": "US",
"telephone_number": "704-373-0212",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 Medical Park Dr",
"address_2": "Ste 230",
"address_purpose": "LOCATION",
"city": "Concord",
"state": "NC",
"postal_code": "280252982",
"country_code": "US",
"telephone_number": "704-403-1349",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "JEREMIAH",
"middle_name": "PAUL",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-21",
"last_updated": "2023-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-02638",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jdavis631691@CarolinasHealthcareSystem.direct-ci.com",
"affiliation": "Y",
"affiliationName": "Atrium Health",
"address_1": "1237 Harding Pl",
"address_2": "Ste 3100",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282042826",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "ABILITY Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.