Jacob Burley Davis, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG004091 Issued in PA

Practice address

107 Plaza Dr Ste L
Saint Clairsville, OH 43950-8735

Phone

(740) 729-8173

NPI assigned

Nov 2, 2023

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

Medicare fee-for-service enrollment

Enrolled in PA, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

International American University at Puerto Rico - School of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optometric Management Group LLCGroup PAC ID 7517034291, 43 clinicians

Deconcilis Eye and Vision Center, PCGroup PAC ID 6507826351, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacobod@swpa.ecldirect.net

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.

• Optometric Management Group LLC

  • Optometrist
  • Powell, OH
  • NPI 1265534093
  Medicare reassignment Care Compare group NPD
• Deconcilis Eye and Vision Center, PC

  • Optometrist
  • Canonsburg, PA
  • NPI 1801086913
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1811760747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 PLAZA DR STE L",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439508735",
            "telephone_number": "724-745-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 PLAZA DR STE L",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439508735",
            "telephone_number": "740-729-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JACOB",
        "middle_name": "BURLEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG004091",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.007229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Shats, M.D.
• Pradip Datta, PHD, DABCC, FADLM
• Katelynne Rose Davenport
• Ryan C Davenport
• Lenora Davies
• Lawrence John Davis, CDCA
• Ora Leanna Davis
• Tonya Davis
• Linda L Davison, MA CCCA
• Sarah Day, MSW LSW

• Optometrist in Saint Clairsville, OH
• Providers in Saint Clairsville, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; 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.