Stuart Paul Davis, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

046588 Issued in GA

Practice address

16 Eastbrook BND
Suite 202B
Peachtree City, GA 30269-1568

Phone

(770) 486-8600

Fax

(770) 486-8809

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Behavioral Health Professionals of Lagrange, LLC

  • Psychiatry Physician
  • Lagrange, GA
  • NPI 1861016537
  Medicare reassignment NPD

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1811043540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 EASTBROOK BND",
            "address_2": "SUITE 202B",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691568",
            "telephone_number": "770-486-8600",
            "fax_number": "770-486-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 EASTBROOK BND",
            "address_2": "SUITE 202B",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691568",
            "telephone_number": "770-486-8600",
            "fax_number": "770-486-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "STUART",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "046588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Lynn Davis Jr., D.C.
• Matthew Park Davis, D.C.
• Nancy J Davis, D.D.S.
• Preston Chase Davis, DC
• Reva Lychelle Davis
• Katarina Michelle Day
• Lisa Marie Deboer, OTR/L
• Paige Dee, LPC
• Jacqueline Delash, DMD, MBA, MPH
• Dentistry for Children of Peachtree City, LLC

• Psychiatry Physician in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.