Dean Ryan Davis, MD
Individual provider Active NPI Family Medicine Physician · Forsyth, IL
NPI 1700847191 · NPPES record last updated Dec 3, 2020
Key facts
- NPI
- 1700847191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036150782 (IL)
- Practice address
- 241 W Weaver Rd Ste 145a
Forsyth, IL 62535-9765 - Phone
- (217) 876-5270
- Fax
- (217) 875-4001
- NPI assigned
- Mar 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 10
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Decatur Memorial Hospital
Practice addresses (Care Compare)
241 W Weaver Rd
Suite 145a
Forsyth, IL 62535-9765
Phone (217) 876-5270
Hospital & facility affiliations
- Elara Caring V
- Enhabit Home Health
- Advanced Healthcare Services, LLC
- Hospice Care of Illinois
- Decatur Memorial Hospital
- St Marys Hospital
- Kirby Medical Center
- Northwestern Medicine Central Dupage Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 73.88 of 100
- Quality
- 63.91
- Improvement activities
- 40
- Cost
- 77.03
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200219001146 | IL | Practitioner - Family Practice | 9830171321 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036150782 | IL | MD | Family Medicine Physician |
| 125071567 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Springfield Clinic LLP | Current | Accepting new patients | |
| Memorial Health Partners | Family Medicine | Current | Accepting new patients |
| Decatur Memorial Hospital | Family Medicine | Current |
Accepting new patients |
| Illiana Emergency Physicians LLP | Past | Accepting new patients | |
| Illiana Emergency Physicians, LLP | Past | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000
102 W Kenwood Ave
Ste 110
Decatur, IL 62526
Phone (217) 876-5870
241 W Weaver Rd
Ste 145B
Forsyth, IL 62535
Phone (217) 876-5220
241 W Weaver Rd
Ste 145A
Forsyth, IL 62535
Phone (217) 876-5270
520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100
Interoperability endpoints
- deandavis@sfc.allscriptsdirect.net
- deandavis@memorial.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 125071567 | IL | |
| Family Medicine Physician | 207Q00000X | 036150782 | IL | Yes |
Addresses
Primary practice location
241 W Weaver Rd Ste 145a
Forsyth, IL 62535-9765
Mailing address
4155 McClain Dr
Decatur, IL 62526-1238
Phone (217) 875-0227
Other providers in Forsyth, IL
- Catherine E. Cavanaugh
- Ha Young Cho
- Leah Marie Cummings
- Karen S Cycotte
- Nicole Dalton
- Sunni Leigh Delahunty
- David A Di Mauro
- Blake Andrew Doss
- Dr. Karen S. Cycotte, OD, LLC
- Dr. Karen S. Cycotte,O.D.,LLC
All providers in Forsyth, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.