Individual provider Active NPI

James B Davis, M.D.

  • Pediatrics Physician
  • West Jordan, UT
National Provider Identifier
1780905083
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD60747018 Issued in WA
Practice address
2655 W 9000 S
West Jordan, UT 84088-8542
Phone
(801) 568-9933
Fax
(801) 256-6344
NPI assigned
Jun 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 245512 MA
Pediatrics Physician 208000000X MD60747018 WA Primary
Pediatrics Physician 208000000X 8692257-1205 UT

Addresses

Primary practice location

2655 W 9000 S
West Jordan, UT 84088-8542

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (401) 226-8651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20201030002498 WA Practitioner - Pediatric Medicine 0648413880 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
245512MAMDPediatrics Physician
8692257-1205UTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Oct 26, 2020 Accepting new patients
Multicare Health System CurrentSince Oct 26, 2020 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 319
Gig Harbor, WA 98335
Phone (253) 530-8328

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1780905083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "401-226-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840888542",
            "telephone_number": "801-568-9933",
            "fax_number": "801-256-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAMES",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-21",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "245512",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60747018",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "8692257-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

Verify at the official NPI Registry.