Jason J Davis, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

22519 Issued in NE

Practice address

5625 S 62ND St Ste 100
Lincoln, NE 68516-3558

Phone

(402) 489-3834

Fax

(402) 489-5049

NPI assigned

Jun 29, 2006

Last updated

Apr 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lincoln Pediatric Group LLC

  • Pediatrics Physician
  • Lincoln, NE
  • NPI 1083640130
  NPD
• Lincoln Pediatric Group LLC

  • Pediatrics Physician
  • Lincoln, NE
  • NPI 1508389610
  NPD

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1841228798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 S 62ND ST STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163558",
            "telephone_number": "402-489-3834",
            "fax_number": "402-489-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 S 62ND ST STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685163558",
            "telephone_number": "402-489-3834",
            "fax_number": "402-489-5049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JASON",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "22519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47049487112",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "238921",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "31574",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "12 01036",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsi Ann Klentz Davis, PHD
• Cristina Lynne Davis, MA
• Elisha Marie Davis, RN
• Jaisa Michelle Davis
• Jamie Davis
• Jennifer Ann Davis
• Jennifer C Davis, MA
• Konner Kameaiomakamae Davis
• Lisa Davis
• Michaela Renee Davis

• Pediatrics Physician in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Pediatrics Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.