Davis Optometry Group PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DAVIS OPTOMETRY GROUP PA

Practice address

2922 Jefferson St
Marianna, FL 32446-3448

Phone

(850) 526-4550

Fax

(850) 526-1200

NPI assigned

Jan 2, 2007

Last updated

May 15, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Robin Mary Medina

Title

Office Manager

Phone

(850) 526-4550

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey K. Davis, OD

  • Optometrist
  • Marianna, FL
  • NPI 1659347698
  Medicare reassignment Care Compare group NPD
• Marion Bert Davis Jr., OD

  • Optometrist
  • Marianna, FL
  • NPI 1881660827
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242345600000",
    "number": "1831256726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2922 JEFFERSON ST",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324463448",
            "telephone_number": "850-526-4550",
            "fax_number": "850-526-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2922 JEFFERSON ST",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324463448",
            "telephone_number": "850-526-4550",
            "fax_number": "850-526-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS OPTOMETRY GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2009-05-15",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-526-4550",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC -C",
            "identifier": "0574680001",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078275100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Blackwell Bryan MD PA
• Cypress Medical Care Services
• Carolyn Dachinger, MT-BC
• John Daniels
• Wilanne Daniels
• Andrea Davis, CRNA
• Jeffrey K. Davis, OD
• Marion Bert Davis Jr., OD
• Brenda G Dean, ARNP
• Murphy Elizabeth Debaat Doelman, OTR/L

• Optometrist in Marianna, FL
• Providers in Marianna, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.