Individual provider Active NPI

Jeffrey Dean Davis, MD

  • Internal Medicine Physician
  • Charlottesville, VA
National Provider Identifier
1891758140
Registry record updated Dec 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101050714 Issued in VA
Practice address
1011 East Jefferson St
Ste 202
Charlottesville, VA 22902-5354
Phone
(434) 977-7950
Fax
(434) 295-4470
NPI assigned
Apr 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101050714 VA Primary

Addresses

Primary practice location

1011 East Jefferson St
Ste 202
Charlottesville, VA 22902-5354

Mailing address

1011 East Jefferson St
Ste 202
Charlottesville, VA 22902-5354
Phone (434) 977-7950

Other practice location 1

1011 E Jefferson St Ste 202
Charlottesville, VA 22902-5354
Phone (434) 654-2800

Other identifiers 2

IdentifierTypeStateIssuer
006009395MedicaidVA
020359OtherVABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20101101001268 VA Practitioner - Internal Medicine 0244370088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Virginia School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Martha Jefferson Medical Group LLCGroup PAC ID 5991889081, 197 clinicians

Practice addresses (Care Compare)

140 Stoneridge Dr S
Ruckersville, VA 22968-3096
Phone (434) 654-1850

1646 Park Ridge Dr
Crozet, VA 22932-3155
Phone (434) 654-2760

2250 Ivy Rd
Suite 220
Charlottesville, VA 22903-4977
Phone (434) 654-3710

590 Peter Jefferson Pkwy
Suite 100
Charlottesville, VA 22911-4628
Phone (434) 654-8930

Hospital & facility affiliations

  • Sentara Home Care Services Home health agency, Charlottesville, VA, CCN 497019
  • At Home Care Home health agency, Mechanicsvlle, VA, CCN 497493
  • Interim Healthcare - Charlottesville Home health agency, Charlottesville, VA, CCN 497447
  • Sentara Martha Jefferson Hospital Hospital, Charlottesville, VA, CCN 490077
  • University of Virginia Medical Center Hospital, Charlottesville, VA, CCN 490009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101050714VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Jefferson Medical Group LLC Internal Medicine CurrentSince Jan 21, 2019 Accepting new patients
Martha Jefferson Hospital Past Accepting new patients

Locations

2250 Ivy Rd
Ste 200
Charlottesville, VA 22903
Phone (434) 654-4550

1011 E Jefferson St
Ste 202
Charlottesvle, VA 22902
Phone (434) 654-2800

500 Martha Jefferson Dr
Charlottesvle, VA 22911
Phone (434) 654-7000

1646 Park Ridge Dr
Crozet, VA 22932
Phone (434) 654-2760

Interoperability endpoints

  • Direct secure messaging: jdavis246329@direct.sentara.net

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 and National Provider Directory roles.

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": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1891758140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 EAST JEFFERSON ST",
            "address_2": "STE 202",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025354",
            "telephone_number": "434-977-7950",
            "fax_number": "434-295-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 EAST JEFFERSON ST",
            "address_2": "STE 202",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229025354",
            "telephone_number": "434-977-7950",
            "fax_number": "434-295-4470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 E Jefferson St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229025354",
            "country_code": "US",
            "telephone_number": "434-654-2800",
            "fax_number": "434-979-3157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JEFFREY",
        "middle_name": "DEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101050714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006009395",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "020359",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.