Derek Davis, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

58005077 Issued in OH

Practice address

1805 27TH St
Portsmouth, OH 45662-2640

Phone

(740) 356-5000

Fax

(740) 353-7900

NPI assigned

Oct 11, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Emergency Medicine

Education

Ohio University, College of Osteopathic Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Emergency Care Services IncGroup PAC ID 9436475795, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ddavis636754@direct.bsmhealth.org

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.

• Mercy Emergency Care Services, Inc.

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1477957819
  Medicare reassignment Care Compare group NPD
• Emergency Professional Services, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353
  Medicare reassignment NPD
• Epmg of Ohio Inc P a

  • Emergency Medicine Physician
  • Portsmouth, OH
  • NPI 1841232196
  Medicare reassignment NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

• Mercy Health-St Ritas Medical Center LLC

  • Psychiatric Hospital Unit
  • Lima, OH
  • NPI 1447276936
  Care Compare affiliation
• Mercy Health-St Ritas Medical Center LLC

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1811939887
  Care Compare affiliation

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

{
    "created_epoch": "1381449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381449600000",
    "number": "1740617562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST",
            "address_2": "WALLER BLDG. SUITE B 06",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622677",
            "telephone_number": "740-356-8051",
            "fax_number": "740-353-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 27TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622640",
            "telephone_number": "740-356-5000",
            "fax_number": "740-353-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DEREK",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-11",
        "last_updated": "2013-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "58005077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antoine Davis
• Brandilyn Ann Davis, PHARMD
• Brett J Davis, RPH
• Caleb Ross Davis, DPM
• Cheyanne Davis
• Elizabeth Ann Davis, LPN
• Jennifer Davis
• Jessica Davis
• Jordan Davis
• Karen M Davis

• Emergency Medicine Physician in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2013; 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.