Terry Norman Davis Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2503 Issued in WV

Practice address

1 Medical Center Dr
Clarksburg, WV 26301

Phone

(304) 623-3461

NPI assigned

Jul 22, 2021

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1932772308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "26301",
            "telephone_number": "304-623-3461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "26301",
            "telephone_number": "304-623-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TERRY",
        "middle_name": "NORMAN",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-22",
        "last_updated": "2021-08-16",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "2503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1183198",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEST VIRGINIA STATE LICENSE",
            "identifier": "2503",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Davis, PHARMD
• Courtney D Davis, LMT
• Debra Ann Davis, MA EDS
• Mary Ann Davis, P.T.A.
• Suzanna Davis
• Tiffany D Davis
• Davisson Run Leasing Co., LLC (Clarksburg Healthcare Center)
• Candice Marie Davisson
• Kayla Marie Davisson
• Nancy Davisson, CNM

• Physician Assistant in Clarksburg, WV
• Providers in Clarksburg, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.