Emily Davis

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003189 Issued in CT

Practice address

192 E Center St
Manchester, CT 06040-5210

Phone

(860) 649-3243

Fax

(860) 649-5092

NPI assigned

Oct 15, 2014

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812
  Medicare reassignment
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD
• Prospect CT Medical Foundation, Inc.

  • Family Medicine Physician
  • Manchester, CT
  • NPI 1144677568
  NPD (past)

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1750785051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 NAEK RD",
            "address_2": "SUITE 5",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060663942",
            "telephone_number": "860-872-2289",
            "fax_number": "860-896-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405210",
            "telephone_number": "860-649-3243",
            "fax_number": "860-649-5092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "EMILY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-15",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "003189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "061496224",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edavis139635@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1075 Asylum Ave",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061052455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David C. Moyer, PHD., P.C.
• David Van Hoewyk, D.C., PC
• Steven T Davies, L.P.C.
• Alishia M Davis
• Daphne Davis
• Lakesha Davis
• Marquia Davis
• Peta-Gaye Davis
• Rochelle L Davis
• Tonya R Davis

• Physician Assistant in Manchester, CT
• Providers in Manchester, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.