Jennifer M Davis, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0101253379 Issued in VA

Practice address

8008 Westpark Dr
Kaiser Permanente Tysons Corner Medical Center
MC Lean, VA 22102-3109

Phone

(703) 287-6400

NPI assigned

May 23, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Centra Medical Group Southside, LLC

  • Family Medicine Physician
  • Farmville, VA
  • NPI 1841479565
  NPD (past)

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

{
    "created_epoch": "1243036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1871728543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8008 WESTPARK DR",
            "address_2": "KAISER PERMANENTE TYSONS CORNER MEDICAL CENTER",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023109",
            "telephone_number": "703-287-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8008 WESTPARK DR",
            "address_2": "KAISER PERMANENTE TYSONS CORNER MEDICAL CENTER",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023109",
            "telephone_number": "703-287-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-23",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "DC",
            "license": "MD042730",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0078516",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101253379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8008 Westpark Dr",
            "address_2": "Kaiser permanente Tysons corner medical center",
            "city": "Mc Lean",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221023109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Richard Michael Davidson, O.D.
• Davis Cares Home Healthcare LLC
• Diana Davis, PSY.D.
• Erika Davis, LPC
• Jeffrey Paul Davis, D.D.S.
• John Davis
• Tara Alese Dawkins, PT, DPT
• Katelyn Day, CNM
• DD Loving Home Health Care, LLC.
• Patricia De Arbeloa, MD

• Emergency Medicine Physician in McLean, VA
• Providers in McLean, VA by specialty
• Emergency Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.