Active NPI
Dennis Allan Davis, MD
- Surgery Physician
- Martin, TN
National Provider Identifier
1801838859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 46558
- Practice address
- 143 Kennedy Dr
Martin, TN 38237-3309 - Phone
- (731) 587-5321
- Fax
- (731) 588-3229
- NPI assigned
- Jun 12, 2006
- Last updated
- Jan 3, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 28963 | GA | |
| Surgery Physician | 208600000X | 46558 | TN | Primary |
Addresses
Primary practice location
143 Kennedy Dr
Martin, TN 38237-3309
Mailing address
143 Kennedy Dr
Martin, TN 38237-3309
Phone (731) 587-5321
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010015387 | Other | GA | RAILROAD MEDICARE |
| 00328391A | Medicaid | GA | |
| 1522027 | Medicaid | TN | |
| 237034DA | Other | GA | BC/BS |
| 4277903 | Other | TN | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28963 | GA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325548800000",
"number": "1801838859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 KENNEDY DR",
"city": "MARTIN",
"state": "TN",
"postal_code": "382373309",
"telephone_number": "731-587-5321",
"fax_number": "731-588-3229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "143 KENNEDY DR",
"city": "MARTIN",
"state": "TN",
"postal_code": "382373309",
"telephone_number": "731-587-5321",
"fax_number": "731-588-3229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DENNIS",
"middle_name": "ALLAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2012-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "28963",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TN",
"license": "46558",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "010015387",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00328391A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1522027",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "237034DA",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4277903",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Martin, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.