Individual provider Active NPI

Robert Davis, D.O.

  • Internal Medicine Physician
  • Norton, VA
National Provider Identifier
1851767552
Registry record updated Aug 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0102205021 Issued in VA
Practice address
100 15TH St NW
Norton, VA 24273-1616
Phone
(276) 679-3488
NPI assigned
Aug 17, 2015
Last updated
Aug 11, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0116028755 VA
Internal Medicine Physician 207R00000X 0102205021 VA Primary

Addresses

Primary practice location

100 15TH St NW
Norton, VA 24273-1616

Mailing address

100 15TH St NW
Norton, VA 24273-1616
Phone (276) 679-3488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20181001000224 TN Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 6305104852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine, Osteopathic Manipulative Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Tennessee Healthcare Hospitalists IncGroup PAC ID 1951735521, 98 clinicians

Practice addresses (Care Compare)

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-4923

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3544TNMDClinical Psychologist
0116028755VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Tennessee Healthcare Hospitalists Inc CurrentSince Sep 25, 2019 Accepting new patients
West Tennessee Medical Group Inc Internal Medicine Past Accepting new patients

Locations

1804 Highway 45 Byp
Ste 604
Jackson, TN 38305
Phone (731) 512-1273

620 Skyline Dr
Jackson, TN 38301
Phone (731) 425-5000

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502409600000",
    "number": "1851767552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 15TH ST NW",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731616",
            "telephone_number": "276-679-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 15TH ST NW",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731616",
            "telephone_number": "276-679-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROBERT",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-17",
        "last_updated": "2017-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0116028755",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102205021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton, VA

Sources for this page

Verify at the official NPI Registry.