NPIMap

Individual provider Active NPI

Chad A. Davis, M.D.

  • Emergency Medicine Physician
  • Walsenburg, CO
National Provider Identifier
1922081090
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
40395 Issued in CO
Practice address
23500 US Highway 160
Walsenburg, CO 81089-9524
Phone
(719) 738-5100
Fax
(719) 738-5138
NPI assigned
Nov 22, 2005
Last updated
Jun 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01082982A IN
Emergency Medicine Physician 207P00000X 40395 CO Primary

Addresses

Primary practice location

23500 US Highway 160
Walsenburg, CO 81089-9524

Mailing address

23500 US Highway 160
Walsenburg, CO 81089-9524
Phone (719) 738-5100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address spanishpeaksregionalhealth@direct.summit-healthcare.orgq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20090102000256 CO Practitioner - Emergency Medicine 9830095421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

23500 US Hwy 160
Walsenburg, CO 81089-9524
Phone (719) 738-5100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.89 of 100Reported as apm
Quality
86.88
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40395COMDEmergency Medicine Physician
01082982AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Pathology Group, PC Current Accepting new patients
Huerfano County Hospital District CurrentSince Aug 18, 2020 Accepting new patients
Huerfano County Hospital District CurrentSince Aug 18, 2020 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Past Accepting new patients
Trinidad Area Health Association Past Accepting new patients

Locations

1008 Minnequa Ave
Pueblo, CO 81004
Phone (719) 557-5656

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

23500 US Highway 160
Walsenburg, CO 81089
Phone (719) 738-5100

Interoperability endpoints

  • Direct secure messaging: chad.davis.md@direct.sprhc.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1922081090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23500 US HIGHWAY 160",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810899524",
            "telephone_number": "719-738-5100",
            "fax_number": "719-738-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23500 US HIGHWAY 160",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810899524",
            "telephone_number": "719-738-5100",
            "fax_number": "719-738-5138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHAD",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01082982A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "40395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "spanishpeaksregionalhealth@direct.summit-healthcare.orgq",
            "affiliation": "N",
            "endpointDescription": "Chad Davis Spanish Peaks Pro Fees Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "23500 US Highway 160",
            "city": "Walsenburg",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810899524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walsenburg, CO

Sources for this page

Verify at the official NPI Registry.