Lisa M Davis, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9106059 Issued in FL

Practice address

6015 Pointe West Blvd
Bradenton, FL 34209-5525

Phone

(941) 792-1404

Fax

(941) 296-7662

NPI assigned

Oct 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• MD Now Medical Centers Inc

  • Urgent Care Clinic/Center
  • West Palm Beach, FL
  • NPI 1033195474

  FL

  Medicare reassignment
• Palms of Pasadena Emergency Physicians LLC

  • Emergency Medicine Physician
  • South Pasadena, FL
  • NPI 1164436341
  NPD (past)
• Pride Emergency Physicians LLC

  • Emergency Medicine Physician
  • Sarasota, FL
  • NPI 1740416015
  NPD (past)
• Town & Country Emergency Physicians LLC

  • Emergency Medicine Physician
  • Tampa, FL
  • NPI 1629024088
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310083200000",
    "number": "1902996945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 POINTE WEST BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095525",
            "telephone_number": "941-792-1404",
            "fax_number": "941-296-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 POINTE WEST BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095525",
            "telephone_number": "941-792-1404",
            "fax_number": "941-296-7662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2011-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004249",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Davis III
• Jeffrey M Davis, MD
• Kurtis R Davis, D.M.D.
• Kylee Davis
• Lisa M Davis, L.M.H.C., PH.D.
• Mayleigh Davis
• Monica Jean Davis, LMHC
• Ruth Ann Davis, APRN
• Shane K Davis, LMHC
• Davita Medical Florida, Inc.

• Physician Assistant in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.