Samuel M. Davis, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

35-085824 Issued in OH

Practice address

4102 Pinion Dr
Suite 100
Usaf Academy, CO 80840-2502

Phone

(719) 333-5005

NPI assigned

Jan 24, 2006

Last updated

Apr 18, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Nes Ohio Inc

  • Emergency Medicine Physician
  • Barnesville, OH
  • NPI 1043699200
  NPD (past)

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240012800000",
    "number": "1730159666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 ALL SKY DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809212886",
            "telephone_number": "937-974-3407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "address_2": "SUITE 100",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SAMUEL",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2009-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35-085824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "000000371925",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Porter Cunningham, DDS
• Micaela Jane Dagucon, M.D.
• Hugo Adriano Davalos Jr., PA-C
• Christopher Davis III
• Johnny Elbert Davis Jr., PA-C
• Jeffrey M Daxe, CRNA
• Mikalyn T Defoor, MD
• Stephanie Ann Degen, M.D.
• Bruce Lowell Deitsch, N.P.
• Denver Vamc

• Emergency Medicine Physician in Usaf Academy, CO
• Providers in Usaf Academy, CO by specialty
• Emergency Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.