NPIMap

Organization Active NPI

Davis Medical Clinic, SC

  • Internal Medicine Physician
  • Mequon, WI
National Provider Identifier
1770538100
Registry record updated Aug 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
DAVIS MEDICAL CLINIC, SC
Practice address
1516 W Mequon Rd
Suite 103
Mequon, WI 53092-3264
Phone
(262) 242-0700
Fax
(262) 242-0710
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2009

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

Authorized official

Name
Marsha Davis, MD
Title
President
Phone
(262) 242-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1516 W Mequon Rd
Suite 103
Mequon, WI 53092-3264

Mailing address

1516 W Mequon Rd
Suite 103
Mequon, WI 53092-3264
Phone (262) 242-0700

National Provider Directory

National Provider Directory

Locations

1220 W Ranchito Ln
Mequon, WI 53092
Phone (262) 240-9000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9435/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251158400000",
    "number": "1770538100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1516 W MEQUON RD",
            "address_2": "SUITE 103",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923264",
            "telephone_number": "262-242-0700",
            "fax_number": "262-242-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 W MEQUON RD",
            "address_2": "SUITE 103",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923264",
            "telephone_number": "262-242-0700",
            "fax_number": "262-242-0710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS MEDICAL CLINIC, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2009-08-25",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-242-0700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; 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.