Glen Priester Davis, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

239049 Issued in NY

Practice address

198 E 121St St
New York, NY 10035-3523

Phone

(212) 803-2727

Fax

(646) 335-0667

NPI assigned

May 2, 2007

Last updated

Mar 12, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NY

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

Specialty

Psychiatry

Education

JS Weill Medical College, Cornell University, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Institute for Community Living , Inc.Group PAC ID 3870482391, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: glen.davis.1@24284.direct.athenahealth.com

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.

• Institute for Community Living , Inc.

  • Community/Behavioral Health Agency
  • Brooklyn, NY
  • NPI 1558494930
  Medicare reassignment Care Compare group NPD
• Janian Medical Care, P.C.

  • Psychiatry Physician
  • New York, NY
  • NPI 1871926782
  Medicare reassignment
• Inpathy Behavioral Healthcare Group LLC

  • Psychiatry Physician
  • Marlton, NJ
  • NPI 1285099325
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1912128356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 E 121ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353523",
            "telephone_number": "212-803-2727",
            "fax_number": "646-335-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 E 121ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353523",
            "telephone_number": "212-803-2727",
            "fax_number": "646-335-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GLEN",
        "middle_name": "PRIESTER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NY",
            "license": "239049",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "239049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emilee C Davis, ATR-BC, LPAT
• Emily Sarah Davis, MD, MED
• Francis Davis, PSY.D.
• Gabriel S Davis, MD
• Gabrielle Davis
• Gregory Lee Davis, M.D.
• Heather Davis, RD
• Henry Wesley Davis
• Hilrette Davis
• Jaclyn Carey Davis, M.D.

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; 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.