NPIMap

Individual provider Active NPI

Matthew Jonathon Davis, M.D.

  • Surgery Physician
  • Cordova, TN
National Provider Identifier
1710253117
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
57973 Issued in TN
Practice address
57 Germantown CT Ste 204
Cordova, TN 38018
Phone
(901) 758-7888
Fax
(901) 266-6445
NPI assigned
Mar 29, 2012
Last updated
Sep 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 20860000X OH
Surgery Physician 208600000X 57973 TN Primary

Addresses

Primary practice location

57 Germantown CT Ste 204
Cordova, TN 38018

Mailing address

P O Box 1000 Dept 457
Memphis, TN 38148-0001
Phone (901) 275-3662

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, OH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181002001492 TN Practitioner - General Surgery 5496057358 Reassigns benefits to 1 organization
I20240815004441 OH Practitioner - General Surgery 5496057358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

960 Clague Rd
Westlake, OH 44145-1586

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.15 of 100Reported as apm
Quality
82.31
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy31
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)11
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20860000XOHMDSurgery Physician
57973TNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
Ut Methodist Physicians LLC Surgery CurrentSince Oct 1, 2018 Accepting new patients
The Metrohealth System Current Accepting new patients
University Primary Care Practices Inc CurrentSince Aug 1, 2024 Accepting new patients
University Primary Care Practices Inc CurrentSince Aug 1, 2024 Accepting new patients
Methodist Healthcare - Memphis Hospitals PastSince Oct 1, 2018 Accepting new patients
University Primary Care Practices Past Accepting new patients
University Hospitals Medical Group Inc Surgery Past Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

57 Germantown Ct
Ste 204
Cordova, TN 38018
Phone (901) 758-7840

1325 Eastmoreland Ave
Ste 370
Memphis, TN 38104
Phone (901) 516-8785

Interoperability endpoints

  • Direct secure messaging: mdavis55261@direct.metrohealth.org
  • Direct secure messaging: mdavis590128@ehrdirect.uhhospitals.org

Organizations & group practices 8

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.

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1710253117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 1000 DEPT 457",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381480001",
            "telephone_number": "901-275-3662",
            "fax_number": "901-271-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 GERMANTOWN CT STE 204",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "38018",
            "telephone_number": "901-758-7888",
            "fax_number": "901-266-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MATTHEW",
        "middle_name": "JONATHON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-29",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "20860000X",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "57973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordova, TN

Sources for this page

Verify at the official NPI Registry.