Bradley Carl Davis, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

ME146799 Issued in FL

Practice address

1305 Lakeland Hills Blvd
Lakeland, FL 33805-4542

Phone

(863) 688-2334

Fax

(863) 577-1160

NPI assigned

Jul 23, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, UT2 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

Diagnostic Radiology

Education

Medical College of Wisconsin, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology and Imaging Specialists of LakelandGroup PAC ID 2264422294, 70 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Winter Haven Hospital Hospital, Winter Haven, FL, CCN 100052
• Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157
• Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299
• Manatee Memorial Hospital Hospital, Bradenton, FL, CCN 100035
• Adventhealth Heart of Florida Hospital, Davenport, FL, CCN 100137

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 91)

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

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.

• Radiology & Imaging Specialists of Lakeland

  • Diagnostic Radiology Physician
  • Lakeland, FL
  • NPI 1427049931

  AZ, UT

  Medicare reassignment Care Compare group NPD
• Associated Valley Radiologists LTD

  • Diagnostic Radiology Physician
  • Glendale, AZ
  • NPI 1932683257
  Medicare reassignment NPD
• Evac LLC

  • Nephrology Physician
  • Chandler, AZ
  • NPI 1073772588

  Vascular & Interventional Radiology

  Medicare reassignment NPD
• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708

  Diagnostic Radiology

  Medicare reassignment NPD
• Radiology & Imaging Specialists of Lakeland, PA

  • Vascular & Interventional Radiology Physician
  • Lakeland, FL
  • NPI 1063032993

  Diagnostic Radiology

  NPD (past)
• Radiology & Imaging Specialists of Lakeland, PA

  • Diagnostic Radiology Physician
  • Kissimmee, FL
  • NPI 1124530761
  NPD (past)
• Scottsdale Medical Imaging, LTD

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
  • NPI 1407823610
  NPD (past)

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

• Adventhealth Polk North Inc

  • General Acute Care Hospital
  • Davenport, FL
  • NPI 1801457510
  Care Compare affiliation
• Lakeland Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Lakeland, FL
  • NPI 1144228446
  Care Compare affiliation
• Lakewood Ranch Medical Center

  • General Acute Care Hospital
  • Bradenton, FL
  • NPI 1730179714
  Care Compare affiliation
• Manatee Memorial Hospital L P

  • General Acute Care Hospital
  • Bradenton, FL
  • NPI 1760472799
  Care Compare affiliation
• Winter Haven Hospital Inc

  • General Acute Care Hospital
  • Winter Haven, FL
  • NPI 1477599975
  Care Compare affiliation

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1801026893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 CRYSTAL GROVE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338016875",
            "telephone_number": "863-688-2334",
            "fax_number": "863-577-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054542",
            "telephone_number": "863-688-2334",
            "fax_number": "863-577-1160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6424 E Broadway Rd",
            "address_2": "Ste 101",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852061750",
            "country_code": "US",
            "telephone_number": "480-456-9000",
            "fax_number": "480-632-1153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRADLEY",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-23",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "50439",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "AZ",
            "license": "50439",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME146799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018841",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janett Fernandez Davila
• Pam Davila, MA CCC-SLP
• Toi Davis-Washington, APRN
• Altovise L Davis
• Amanda Lueshen Davis, MD
• Carolin Davis, BCBA
• Donald M Davis, M.D.
• Ellen Davis
• Heidi Davis
• Jermaine Davis

• Diagnostic Radiology Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Diagnostic Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.