Active NPI
Paul H Davis, M.D.
- Family Medicine Physician
- Wichita, KS
National Provider Identifier
1710980164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 04-15371
- Practice address
- 7111 E 21St Street N
Suite a
Wichita, KS 67206 - Phone
- (316) 684-2851
- Fax
- (316) 686-7338
- NPI assigned
- May 31, 2005
- Last updated
- Oct 16, 2012
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 04-15371 | KS | Primary |
Addresses
Primary practice location
7111 E 21St Street N
Suite a
Wichita, KS 67206
Mailing address
7111 E 21St Street N
Suite a
Wichita, KS 67206
Phone (316) 684-2851
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100416440A | Medicaid | KS | |
| 080186352 | Other | KS | RAILROAD MEDICARE |
| 110718 | Other | KS | BLUE CROSS |
| 100086530E | Medicaid | KS | |
| 101598 | Other | KS | BLUE CROSS INDIVIDUAL |
| 621151 | Other | KS | FIRSTGUARD |
| 101598 | Other | KS | CHAMPUS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Oklahoma College of Medicine, 1972
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2600 Compass Rd
Glenview, IL 60026-8001
7111 E 21St St N
Suite a
Wichita, KS 67206-1078
Phone (316) 684-2851
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04-15371 | KS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Care Associates, LLC | Family Medicine | Current | Accepting new patients |
| Line Medical Inc | Past | Accepting new patients |
Locations
7111 E 21st St N
Ste A
Wichita, KS 67206
Phone (316) 684-2851
Interoperability endpoints
- paul.davis.1@3862.direct.athenahealth.com
- paul.davis@khindirect.org
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Wichita, KS
- NPI 1003832403
-
- Rehabilitation Clinic/Center
- Glenview, IL
- NPI 1346368248
-
- Diagnostic Radiology Physician
- Kingman, KS
- NPI 1124083308
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Wesley Healthcare at Home
- Home Health Agency
- Salina, KS
- NPI 1568764520
-
dba Ascension at Home
- Home Health Agency
- Wichita, KS
- NPI 1235132119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350345600000",
"number": "1710980164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7111 E 21ST STREET N",
"address_2": "SUITE A",
"city": "WICHITA",
"state": "KS",
"postal_code": "67206",
"telephone_number": "316-684-2851",
"fax_number": "316-686-7338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7111 E 21ST STREET N",
"address_2": "SUITE A",
"city": "WICHITA",
"state": "KS",
"postal_code": "67206",
"telephone_number": "316-684-2851",
"fax_number": "316-686-7338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "PAUL",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-31",
"last_updated": "2012-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "04-15371",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100416440A",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080186352",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "110718",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100086530E",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS INDIVIDUAL",
"identifier": "101598",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRSTGUARD",
"identifier": "621151",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "101598",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.