James Bradley Davis, P.A.-C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

103792-1206 Issued in UT

Practice address

5770 South 250 East
Suite 135
Salt Lake City, UT 84107-8241

Phone

(801) 314-2225

Fax

(801) 314-2345

NPI assigned

Mar 23, 2006

Last updated

Sep 18, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Robert Berry, M.D.

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  • NPI 1982673505
  Medicare reassignment

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1922068212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5770 SOUTH 250 EAST",
            "address_2": "SUITE 135",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841078241",
            "telephone_number": "801-314-2225",
            "fax_number": "801-314-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5770 SOUTH 250 EAST",
            "address_2": "SUITE 135",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841078241",
            "telephone_number": "801-314-2225",
            "fax_number": "801-314-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAMES",
        "middle_name": "BRADLEY",
        "name_prefix": "Mr.",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "103792-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harmony Davis
• Hayden Davis
• Hillary Davis, PA-C
• Ivy Elizabeth Davis I
• James Davis
• Jeffrey Lynn Davis, PA
• Jennifer Jean Davis
• Jeremy J Davis, PSY.D.
• Jessica Davis, M.D.
• Jessie Davis, DO

• Physician Assistant in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.