Lara M Davis, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005217 Issued in MI

Practice address

3452 Genesys Pkwy
Grand Blanc, MI 48439-7334

Phone

(810) 606-7550

NPI assigned

Oct 24, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Lara M Gale Former name

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesys Practice Partners IncGroup PAC ID 3476456492, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ldavis1124641@direct.hfhs.org
• Direct secure messaging: lara.davis.1@8209.direct.athenahealth.com

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.

• Genesys Practice Partners Inc

  • Family Medicine Physician
  • Grand Blanc, MI
  • NPI 1982647004
  Medicare reassignment Care Compare group
• Genesys Practice Partners Inc

  • Physician Assistant
  • Grand Blanc, MI
  • NPI 1114060837
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health Genesys Hospital

  • General Acute Care Hospital
  • Grand Blanc, MI
  • NPI 1407877723
  Care Compare affiliation

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1740364124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3452 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397334",
            "telephone_number": "810-606-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3452 GENESYS PKWY",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397334",
            "telephone_number": "810-606-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LARA",
        "middle_name": "M",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lara.davis@migra.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "Ascension Medical Group Genesys Heart Institute",
            "address_1": "3452 Genesys Pkwy",
            "city": "Grand Blanc",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484397334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LARA",
            "last_name": "GALE",
            "middle_name": "M",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Doina David, MD
• Emily J Davidow, DO
• Elizabeth Davis, DPT
• Jamarea Davis
• Jewel Davis
• Leah R Davis, OT
• Letisha Davis
• Narondi Davis
• Sequoia Davis
• Davison Medical Practice PLC

• Physician Assistant in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.

Verify at the official NPI Registry.