Marion Bert Davis Jr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC1401 Issued in FL

Practice address

2922 Jefferson St
Marianna, FL 32446-3448

Phone

(850) 526-4550

Fax

(850) 526-1200

NPI assigned

Feb 28, 2006

Last updated

Jan 5, 2012By 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 5

Other names 1

• M Bert Davis Jr. Professional name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Davis Optometry Group PAGroup PAC ID 8022188077, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Davis Optometry Group PA

  • Optometrist
  • Marianna, FL
  • NPI 1831256726
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1881660827",
    "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": {
        "last_name": "DAVIS",
        "first_name": "MARION",
        "middle_name": "BERT",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PC-ACE PRO 32",
            "identifier": "K6143",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "19031",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410016448",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410016448",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078126600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M",
            "last_name": "DAVIS",
            "middle_name": "BERT",
            "suffix": "JR.",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• John Daniels
• Wilanne Daniels
• Davis Optometry Group PA
• Andrea Davis, CRNA
• Jeffrey K. Davis, OD
• Brenda G Dean, ARNP
• Murphy Elizabeth Debaat Doelman, OTR/L
• Lisa Kathryn Debrauwere, LMT
• Dermatology Associates of Bay County, P.a.
• Sean Despin, LDO 6789

• 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 Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.