Cody C Davis, PA-C
Individual provider Active NPI Physician Assistant · Indian Head, MD
NPI 1912257536 · NPPES record last updated Apr 10, 2024
Key facts
- NPI
- 1912257536
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 5198 (AZ)
- Practice address
- 4141 W Wilson Rd BLDG 1600
Indian Head, MD 20640-5162 - Phone
- (310) 744-1059
- NPI assigned
- Sep 11, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 14
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Emergency Physicians of Tidewater
Practice addresses (Care Compare)
2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone (757) 507-1520
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in MD, DC, VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230731000055 | MD | Practitioner - Physician Assistant | 2668623976 | Reassigns benefits to 4 organizations |
| I20230731000072 | DC | Practitioner - Physician Assistant | 2668623976 | Reassigns benefits to 4 organizations |
| I20250721004194 | VA | Practitioner - Physician Assistant | 2668623976 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Medicine Associates, PA | Current |
Accepting new patients | |
| Emergency Medicine Associates P.a., P.C. | Current |
Accepting new patients | |
| Medstar Urgent Care LLC | Current |
Accepting new patients | |
| WHC Physician Group LLC | Current |
Accepting new patients | |
| Medstar Urgent Care LLC | Current |
Accepting new patients | |
| Emergency Medicine Associates, PA | Current |
Accepting new patients | |
| WHC Emerg Phys | Current |
Accepting new patients | |
| Medstar Urgent Care, LLC | Current |
Accepting new patients | |
| Medstar Medical Group II LLC | Current |
Accepting new patients | |
| Emergency Medicine Associates P.a., P.C. | Current |
Accepting new patients |
Locations
3007 Tilden St NW
Ste 5N
Washington, DC 20008
110 Irving St NW
Washington, DC 20010
Phone (202) 877-2000
1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401
6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890
15001 Health Center Dr
Bowie, MD 20716
Phone (301) 262-5511
3001 S Hanover St
Brooklyn Park, MD 21225
Phone (410) 350-3200
29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300
1406 Crain Hwy S
Glen Burnie, MD 21061
Phone (410) 768-6440
100 Hospital Rd
Prnc Frederck, MD 20678
Phone (410) 414-4791
3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960
11355 Pembrooke Sq
Ste 108
Waldorf, MD 20603
Phone (202) 877-6733
200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000
11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505
1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000
15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000
Interoperability endpoints
- cdavis1017298@direct.umm.edu
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5198 | AZ | Yes |
Addresses
Primary practice location
4141 W Wilson Rd BLDG 1600
Indian Head, MD 20640-5162
Mailing address
4141 W Wilson Rd BLDG 1600
Indian Head, MD 20640-5162
Other providers in Indian Head, MD
- Branch Medical Clinic Indian Head
- Gary A Byrum
- Charles County Health Department
- Hunter Avery Culp
- Bryant Davis
- Dean Natale Del Favero
- Divine Physical Therapy & Pelvic Health
- Krista Nicole Moore Dubois
- Enlighten Therapeutic & Consulting Services, LLC
- Edgar Antonio Escobar
All providers in Indian Head, MD · Physician Assistant in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.