Individual provider Active NPI

Cordula Faye Davis, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1710111489
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2010-01668 Issued in NC
Practice address
5929 South Blvd
Charlotte, NC 28217-4123
Phone
(704) 667-5160
NPI assigned
May 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2010-01668 NC Primary
Pediatrics Physician 208000000X 2010-01668 NC
General Practice Physician 208D00000X 2010-01668 NC

Addresses

Primary practice location

5929 South Blvd
Charlotte, NC 28217-4123

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1940 West Blvd
Charlotte, NC 28208
Phone (980) 402-1660

Other practice location 2

16740 Davidson Concord Rd
Ste 200
Davidson, NC 28036-8746
Phone (704) 444-5881

Other practice location 3

501 Billingsley Rd
Cottage B
Charlotte, NC 28211-1009
Phone (704) 444-5881

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cdavis336717@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120718000000 NC Practitioner - Family Practice 3870759970 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Pittsburgh School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

5929 S Blvd
Charlotte, NC 28217-4123
Phone (704) 667-5160

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2010-01668NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Pediatrics Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 4, 2012 Accepting new patients
Carolinas Pathology Group, PA Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Medical Center CurrentSince Nov 1, 2012 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 4, 2012 Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Feb 1, 2016 Accepting new patients
Carolinas Medical Center CurrentSince Nov 1, 2012 Accepting new patients
Carolinas Medical Center Family Medicine Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Family Medicine Current Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

5727 Prosperity Crossing Dr
Ste 2200
Charlotte, NC 28269
Phone (704) 618-7894

5929 South Blvd
Charlotte, NC 28217
Phone (704) 667-5160

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

5435 Prosperity Church Rd
Ste 2200
Charlotte, NC 28269
Phone (704) 863-9830

501 Billingsley Rd
#B
Charlotte, NC 28211
Phone (704) 444-2400

1801 Rozzelles Ferry Rd
Charlotte, NC 28208
Phone (704) 446-9987

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

251 Eastway Dr
Charlotte, NC 28213
Phone (704) 446-9991

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025
Phone (704) 721-2060

16740 Davidson Concord Rd
Ste 200
Davidson, NC 28036
Phone (704) 444-5881

1896 Remount Rd
Gastonia, NC 28054
Phone (704) 512-3930

447 McAlister Rd
Ste 2400
Lincolnton, NC 28092
Phone (980) 212-6500

4429 W Highway 27
Vale, NC 28168
Phone (704) 748-2245

Interoperability endpoints

  • Direct secure messaging: cdavis336717@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 11

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1710111489",
    "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": "5929 SOUTH BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282174123",
            "telephone_number": "704-667-5160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1940 West Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28208",
            "country_code": "US",
            "telephone_number": "980-402-1660",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16740 Davidson Concord Rd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Davidson",
            "state": "NC",
            "postal_code": "280368746",
            "country_code": "US",
            "telephone_number": "704-444-5881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Billingsley Rd",
            "address_2": "Cottage B",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111009",
            "country_code": "US",
            "telephone_number": "704-444-5881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CORDULA",
        "middle_name": "FAYE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-11",
        "last_updated": "2024-07-17",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2010-01668",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2010-01668",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "2010-01668",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdavis336717@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "5929 South Blvd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282174123",
            "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

Verify at the official NPI Registry.