Michael A. Davis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02487 Issued in TX

Practice address

4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600

Phone

(702) 653-2965

NPI assigned

Mar 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Preferred Hospital Leasing Van Horn Inc

  • Critical Access Hospital
  • Van Horn, TX
  • NPI 1013970862
  NPD (past)
• Regional Employee Assistance Program Inc

  • Cardiovascular Disease Physician
  • Abilene, TX
  • NPI 1073575585

  Physician Assistant

  NPD (past)
• Regional Employee Assistance Program Inc

  • Family Medicine Physician
  • Corsicana, TX
  • NPI 1649232984
  NPD (past)

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1750407623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001174",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Braden Cunningham
• Kelsey Curtis
• Deanna M Daniels, LCSW
• Sylvester Dass
• Jason W David, MD
• Emily De Leon, SURGICAL PA
• Jonathan S Dean, D.D.S.
• John Dedic, MD
• Jessica Defazio, DDS
• Paul Lawrence A Defiesta, MSW, LCSWA, LMSW

• Physician Assistant in Nellis Afb, NV
• Providers in Nellis Afb, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.