Jerry Thomas Davis, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

F9351 Issued in TX

Practice address

6302 A Jacksboro Hwy
Fort Worth, TX 76135-3602

Phone

(817) 237-8273

Fax

(817) 237-0374

NPI assigned

Oct 17, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: jdavis@bcm-tx.direct.office.nextgen.com

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1821179003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3963 BOAT CLUB RD",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761353202",
            "telephone_number": "817-237-8273",
            "fax_number": "817-237-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6302 A JACKSBORO HWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761353602",
            "telephone_number": "817-237-8273",
            "fax_number": "817-237-0374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JERRY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F9351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Nicole Davis, APRN
• James Gregory Davis, MA
• Jason Davis, DPT
• Jennifer Christine Davis, LCDC, LPC-A
• Jenny Davis, OT
• Jessica Nichole Davis
• Jessicah Amber Davis, NNP
• Jonte' Davis
• Julie Davis, PA-C, RD, LD
• Kailey Davis, RBT

• Family Medicine Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.