NPIMap

Individual provider Active NPI

John Russell Davis, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Kansas City, MO
National Provider Identifier
1891775920
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
2010001724 Issued in MO
Practice address
4320 Wornall Rd
Suite 50
Kansas City, MO 64111-5941
Phone
(816) 931-3312
Fax
(816) 531-9862
NPI assigned
Jan 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 2010001724 MO Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 04-34175 KS

Addresses

Primary practice location

4320 Wornall Rd
Suite 50
Kansas City, MO 64111-5941

Mailing address

4320 Wornall Rd
Suite 50
Kansas City, MO 64111-5941
Phone (816) 931-3312

Other identifiers 4

IdentifierTypeStateIssuer
MA1815OtherMOMEDICARE
149549001MedicaidAR
209231208MedicaidMO
200009120AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100511000322 MO Practitioner - Cardiac SurgeryPractitioner - Thoracic SurgeryPractitioner - Vascular Surgery 2365462132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Vascular Surgery
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Heart Surgeons of Kansas City IncGroup PAC ID 5193878072, 36 clinicians

Practice addresses (Care Compare)

4320 Wornall Rd
Kansas City, MO 64111-5941
Phone (816) 932-2000

4320 Wornall Rd
2000 Saint Lukes Clinic
Kansas City, MO 64111-5939
Phone (816) 932-8258

4321 Washington St
Suite 6000
Kansas City, MO 64111-5930
Phone (816) 932-3500

4330 Wornall Rd
Suite 50
Kansas City, MO 64111-3201
Phone (816) 931-3312

4401 Wornall Rd
Mid Heart Lung
Kansas City, MO 64111-3220
Phone (816) 931-3312

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.03 of 100Reported as group
Quality
86.25
Promoting interoperability
100
Improvement activities
40
Cost
77.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Coronary artery bypass graft (CABG)18
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-34175KSMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Surgeons of Kansas City, Inc. Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Feb 1, 2010 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Saint Luke's Physician Group Inc Past Accepting new patients
St Lukes Hospital of Kansas City Past Accepting new patients

Locations

4320 Wornall Rd
Ste 2000
Kansas City, MO 64111
Phone (816) 932-8258

4320 Wornall Rd
Ste 50
Kansas City, MO 64111
Phone (816) 531-5510

Interoperability endpoints

  • FHIR API: https://epicmobile.corp.saint-lukes.org/FHIRPROXY/api/FHIR/R4
  • Direct secure messaging: jdavis4610@direct.saint-lukes.org
  • Direct secure messaging: jdavis142363@stormontvaildirect.org
  • Direct secure messaging: jdavis245137@directc.mercy.net

Organizations & group practices 4

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 7

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1891775920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4320 WORNALL RD",
            "address_2": "SUITE 50",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115941",
            "telephone_number": "816-931-3312",
            "fax_number": "816-531-9862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 WORNALL RD",
            "address_2": "SUITE 50",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641115941",
            "telephone_number": "816-931-3312",
            "fax_number": "816-531-9862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOHN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MO",
            "license": "2010001724",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "KS",
            "license": "04-34175",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "MA1815",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149549001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209231208",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200009120A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.