Neville Davis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R4P82 Issued in MO

Practice address

2511 W Edgewood Dr
Ste D
Jefferson City, MO 65109-5869

Phone

(573) 761-2121

Fax

(573) 635-0726

NPI assigned

Jun 1, 2006

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 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• SSM Regional Health Services

  • General Acute Care Hospital
  • Jefferson City, MO
  • NPI 1518065523
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1790722437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651021027",
            "telephone_number": "573-761-7246",
            "fax_number": "573-761-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 W EDGEWOOD DR",
            "address_2": "STE D",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095869",
            "telephone_number": "573-761-2121",
            "fax_number": "573-635-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "NEVILLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R4P82",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "R4P82",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205754807",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205958408",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "104984",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS MEDICAID",
            "identifier": "2086335801",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "40006670",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "102869",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Ann Daugherty, RPT
• Richard E Daugherty, M.D.
• Sally Joann David, PTA
• Devon Kyle Davis, FNP-C
• Melissa Ann Davis, LPC
• Day Solutions, Inc
• Holly Kristine Day
• Jeanne De Laurier, RN
• Dean Jones Hearing AIDS, Inc.
• Berniece Decker

• Family Medicine Physician in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; 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.