Marguerite Mary Davis, M.D.
Individual provider Active NPI Family Medicine Physician · Danielson, CT
NPI 1942285960 · NPPES record last updated Jan 25, 2008
Key facts
- NPI
- 1942285960
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 031276 (CT)
- Practice address
- 45 Green Hollow Rd
Danielson, CT 06239-3509 - Phone
- (860) 774-1255
- Fax
- (860) 779-2059
- NPI assigned
- Dec 13, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080917000789 | CT | Practitioner - Family Practice | 4082603527 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Day Kimball Medical Group Inc | Family Medicine | Current |
Accepting new patients |
| Danielson Medical Associates, P.C. | Family Medicine | Past |
Accepting new patients |
Locations
132 Westminster Rd
Canterbury, CT 06331
Phone (860) 546-2225
45 Green Hollow Rd
Danielson, CT 06239
Phone (860) 774-1255
612 Hartford Pike
Dayville, CT 06241
Phone (860) 779-0284
320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331
Interoperability endpoints
- marguerite.davis.3@1694.direct.athenahealth.com
- marguerite.davis.2@1694.direct.athenahealth.com
- https://api.platform.athenahealth.com/1694/brand/19/csg/48/fhir/r4
- marguerite.davis.5@1694.direct.athenahealth.com
- marguerite.davis.1@1694.direct.athenahealth.com
- marguerite.davis.4@1694.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 031276 | CT | Yes |
Addresses
Primary practice location
45 Green Hollow Rd
Danielson, CT 06239-3509
Mailing address
45 Green Hollow Rd
Danielson, CT 06239-3509
Phone (860) 774-1255
Other providers in Danielson, CT
- Danielson Pharmacy Inc
- Danielson Pharmacy Inc
- Danielson Pharmacy LLC
- Danielson Pharmacy LLC
- Mary Elizabeth Davidson-Reed
- Tamra J Davis
- Joseph Arthur Deangelis
- Lindsay Delaire
- Jessica Delaney
- Discovery Counseling Services
All providers in Danielson, CT · Family Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2008. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.