Individual provider Active NPI

Thomas S Davis, MD

  • Hematology & Oncology Physician
  • Jacksonville, FL
National Provider Identifier
1710982822
Registry record updated Jun 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME 92693 Issued in FL
Practice address
2 Shircliff Way
Ste 800
Jacksonville, FL 32204-4751
Phone
(904) 388-2619
Fax
(904) 388-0240
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X ME 92693 FL Primary

Addresses

Primary practice location

2 Shircliff Way
Ste 800
Jacksonville, FL 32204-4751

Mailing address

7015 Ac Skinner Parkway
Suite 1
Jacksonville, FL 32256
Phone (904) 363-2113

Other identifiers 5

IdentifierTypeStateIssuer
299126OtherFLAVMED
272581900MedicaidFL
7917565OtherFLAETNA
16027OtherFLBCBS
266033656AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050713000234 FL Practitioner - Hematology/Oncology 8325933740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
New York Medical College, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cancer Specialists LLCGroup PAC ID 9133377948, 46 clinicians

Practice addresses (Care Compare)

121 Whitehall Dr
St Augustine, FL 32086-5266
Phone (904) 825-4500

2370 Market Dr
Fleming Island, FL 32003-4326
Phone (904) 264-6201

5742 Booth Rd
Suite a
Jacksonville, FL 32207-5982
Phone (904) 739-7779

7015 A C Skinner Pkwy
Jacksonville, FL 32256-6932

725 Skymarks Dr
Suite 10 1
Jacksonville, FL 32218-7248
Phone (904) 367-2611

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 92693FLMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer Specialists, LLC CurrentSince Oct 1, 2012 Accepting new patients
Cancer Specialists, LLC Hematology & Oncology CurrentSince Oct 1, 2012 Accepting new patients

Locations

5742 Booth Rd
Ste A
Jacksonville, FL 32207
Phone (904) 739-7779

2 Shircliff Way
Ste 800
Jacksonville, FL 32204
Phone (904) 388-2619

2 Shircliff Way
Jacksonville, FL 32204
Phone (904) 308-7411

Interoperability endpoints

  • Direct secure messaging: tdavis131347@direct.shands.ufl.edu

Organizations & group practices 2

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 3

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": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370476800000",
    "number": "1710982822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7015 AC SKINNER PARKWAY",
            "address_2": "SUITE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-363-2113",
            "fax_number": "904-363-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY",
            "address_2": "STE 800",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044751",
            "telephone_number": "904-388-2619",
            "fax_number": "904-388-0240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "THOMAS",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2013-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME 92693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "299126",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272581900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7917565",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "16027",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266033656A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.