Barbara Davanzo, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

50150 Issued in GA

Practice address

143 Follins LN
St Simons Island, GA 31522-4263

Phone

(912) 634-7714

Fax

(912) 634-7734

NPI assigned

Nov 29, 2007

Last updated

Nov 29, 2007By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2012 through Jul 1, 2028

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Barbara Davanzo, M.D., P.C.

  • Specialist
  • St Simons Island, GA
  • NPI 1164403234
  NPD (past) Authorized official
• William J. Davanzo, M.D., P.C.

  • Specialist
  • Albany, GA
  • NPI 1639150790
  NPD (past)

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1881876175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 FOLLINS LN",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315224263",
            "telephone_number": "912-634-7714",
            "fax_number": "912-634-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 FOLLINS LN",
            "city": "ST SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315224263",
            "telephone_number": "912-634-7714",
            "fax_number": "912-634-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVANZO",
        "first_name": "BARBARA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "50150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00923139A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Beth Currey, LPC
• Elizabeth Thompson Daniel, PT
• William W. Daniels Jr., M.D.
• Katrina Dare, OT
• Larry D. Daugherty, DMD
• David E Vincent MD PC
• David L Patterson, PC
• Hannah Davis, NP-C
• Angela Kathleen Dawson, MD
• Samantha Stringer Delamater

• Psychiatry Physician in St Simons Island, GA
• Providers in St Simons Island, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.