Jonathon Hayes Davis

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2024-00445 Issued in NC

Practice address

Medical Center Boulevard
Winston Salem, NC 27157-0001

Phone

(336) 716-6410

NPI assigned

Mar 31, 2021

Last updated

Jan 6, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NC, GA2 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

Emergency Medicine

Education

University of Cincinnati College of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

The Bortolazzo Group, LLCGroup PAC ID 3476554320, 98 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• The Bortolazzo Group, LLC

  • Emergency Medicine Physician
  • Austell, GA
  • NPI 1801965082
  Medicare reassignment Care Compare group NPD
• Wellstreet of Georgia PC

  dba Piedmont Urgent Care

  • Urgent Care Clinic/Center
  • Newnan, GA
  • NPI 1235411547
  Medicare reassignment Care Compare group NPD
• Wake Forest Emergency Providers

  • Multi-Specialty Clinic/Center
  • Statesville, NC
  • NPI 1396216735
  Medicare reassignment NPD

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1801474671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9425 CHARDON CIR APT 207",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450692945",
            "telephone_number": "614-329-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BOULEVARD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JONATHON",
        "middle_name": "HAYES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "102117",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2024-00445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Warren Davis, CRNA
• Jacqueline Smith Davis, NP
• James M Davis III, M.D.
• Jennifer Doby Davis, AGNP-C
• John F. Davis, MD
• Judson Spencer Davis Jr., CRNA
• Katrina Davis, DNP, FNP-BC
• Keiri Jenae Davis, LMBT
• Kelli Black Davis, MA, CCC-SLP
• Kyra Janae Davis, LCSW

• Emergency Medicine Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.