Active NPI
Mariah Davis, M.D.
- Pediatrics Physician
- Offutt AFB, NE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 32054
- Practice address
- 2501 Capehart Rd
Offutt AFB, NE 68113-1043 - Phone
- (402) 294-6077
- NPI assigned
- Mar 28, 2016
- Last updated
- Oct 21, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2018003022 | MO | |
| Pediatrics Physician | 208000000X | 32054 | NE | Primary |
Addresses
Primary practice location
2501 Capehart Rd
Offutt AFB, NE 68113-1043
Mailing address
2501 Capehart Rd
Offutt AFB, NE 68113-1043
Phone (402) 294-6077
Other practice location 1
4881 Sugar Maple Dr
Wright Patterson AFB, OH 45433-5529
Phone (937) 257-8715
Other names 1
- Mariah Gawlik
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018003022 | MO | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nebraska Methodist Hospital | Current | Accepting new patients | |
| Physicians Clinic Inc | Pediatrics | Current | Accepting new patients |
Locations
10060 Regency Cir
Omaha, NE 68114
Phone (402) 354-1405
825 S 169th St
Omaha, NE 68118
Phone (402) 354-3370
Interoperability endpoints
- mariah.davis@direct.nmhs.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Methodist Physicians Clinic
- Family Medicine Physician
- Omaha, NE
- NPI 1821049156
Pediatrics
-
dba Methodist Hospital
- General Acute Care Hospital
- Omaha, NE
- NPI 1427147883
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571616000000",
"number": "1780046730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2501 CAPEHART RD",
"city": "OFFUTT AFB",
"state": "NE",
"postal_code": "681131043",
"telephone_number": "402-294-6077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 CAPEHART RD",
"city": "OFFUTT AFB",
"state": "NE",
"postal_code": "681131043",
"telephone_number": "402-294-6077"
}
],
"practiceLocations": [
{
"address_1": "4881 Sugar Maple Dr",
"address_purpose": "LOCATION",
"city": "Wright Patterson AFB",
"state": "OH",
"postal_code": "454335529",
"country_code": "US",
"telephone_number": "937-257-8715",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "MARIAH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-28",
"last_updated": "2019-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2018003022",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NE",
"license": "32054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARIAH",
"last_name": "GAWLIK",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Offutt AFB, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.