Individual provider Active NPI

Jillian Diane Davis-Baumann, D.O

  • General Practice Physician
  • Clinton Township, MI
National Provider Identifier
1720315807
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
5101018413 Issued in MI
Practice address
15855 Ninteen Miled Road
Emergency Dept
Clinton Township, MI 48038-3504
Phone
(586) 263-2601
Fax
(586) 263-2589
NPI assigned
Nov 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 5101018413 MI Primary
Emergency Medicine Physician 207P00000X 5101018413 MI

Addresses

Primary practice location

15855 Ninteen Miled Road
Emergency Dept
Clinton Township, MI 48038-3504

Mailing address

38935 Ann Arbor Rd
Credentialing Dept
Livonia, MI 48150-3397
Phone (734) 805-0488

Other identifiers 1

IdentifierTypeStateIssuer
12551412OtherMICAQH

Other names 1

  • Dr. Jillian Diane Davis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20131122000486 MI Practitioner - Emergency Medicine 6709012727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Emergency Care PCGroup PAC ID 3870493588, 21 clinicians

Practice addresses (Care Compare)

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (734) 805-0468

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101018413MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Emergency Care, PC Emergency Medicine CurrentSince Oct 1, 2013 Accepting new patients

Locations

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

38935 Ann Arbor Rd
Livonia, MI 48150
Phone (248) 886-9540

Interoperability endpoints

  • Direct secure messaging: jdavisbaumann219029@direct.hfhs.org

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 2

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": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1720315807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38935 ANN ARBOR RD",
            "address_2": "CREDENTIALING DEPT",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503397",
            "telephone_number": "734-805-0488",
            "fax_number": "866-250-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 NINTEEN MILED ROAD",
            "address_2": "EMERGENCY DEPT",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2601",
            "fax_number": "586-263-2589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-BAUMANN",
        "first_name": "JILLIAN",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-10",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101018413",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101018413",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12551412",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "DAVIS",
            "middle_name": "DIANE",
            "prefix": "DR.",
            "credential": "D.O",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.