Jerry A Davis, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

39878 Issued in WI

Practice address

1836 South Ave
La Crosse, WI 54601-5429

Phone

(608) 782-7300

NPI assigned

Jun 17, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI, MN2 enrollments

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 2

Specialty

Neurosurgery

Education

University of Alabama School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, shared by 16 NPIs, 888 clinicians

Gundersen Clinic LTDGroup PAC ID 9638082779, 422 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gundersen Lutheran Medical Center Hospital, La Crosse, WI, CCN 520087
• Veterans Memorial Hospital Hospital, Waukon, IA, CCN 161318
• Crossing Rivers Health Medical Center Hospital, Prairie Du Chien, WI, CCN 521330

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdavis4284@direct.emplifyhealth.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.

• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115

  MN

  Medicare reassignment Care Compare group NPD
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  Medicare reassignment NPD
• Gundersen Lutheran Medical Center Inc

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1376593442

  MN

  Medicare reassignment NPD
• Gundersen Lutheran Express Care, Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1043446974
  NPD
• Gundersen Lutheran Medical Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD
• Gundersen Clinic LTD

  • Physical Therapy Clinic/Center
  • Caledonia, MN
  • NPI 1649644360
  NPD

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

• Gundersen Lutheran Medical Center Inc

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1376593442
  Care Compare affiliation
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1790646719

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  • Clinic/Center
  • Onalaska, WI
  • NPI 1225372923

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  • Clinic/Center
  • La Crosse, WI
  • NPI 1497090138

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc.

  • Air Ambulance
  • La Crosse, WI
  • NPI 1467468173

  Hospital

  Care Compare affiliation
• Prairie Du Chien Memorial Hospital Association Inc

  • Critical Access Hospital
  • Prairie Du Chien, WI
  • NPI 1619024197
  Care Compare affiliation
• Gundersen Lutheran Medical Center Inc

  • Clinic/Center
  • Winona, MN
  • NPI 1952959603

  Hospital

  Care Compare affiliation
• Veterans Memorial Hospital City of Waukon Ia

  • Critical Access Hospital
  • Waukon, IA
  • NPI 1164599643
  Care Compare affiliation

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1760487573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JERRY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WI",
            "license": "39878",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MN",
            "license": "51338",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32521000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George J Davies, PT
• Breanna Mona Davis
• Bruce K Davis, DDS
• Clark A Davis, MD
• Erin K. Davis, MD
• Raven Simone Davis
• Rhonda Davis, BSW
• Robyn Jo Davis, C.R.N.A.
• David M Dawson, DPM
• Kelly Lee Dawson, D.C.

• Neurological Surgery Physician in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Neurological Surgery Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.