Autumn Deese Davis, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1075178 Issued in GA

Practice address

401 Dixie St
Carrollton, GA 30117-3921

Phone

(678) 796-0681

Fax

(770) 836-8477

NPI assigned

Mar 27, 2007

Last updated

Aug 11, 2014By the provider in NPPES

Sex

Female

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 GA

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

State licenses

Practice roles

Locations

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.

• Columbus Ambulatory Healthcare Services, Inc.

  • Family Medicine Physician
  • Columbus, GA
  • NPI 1790733244
  Medicare reassignment
• Columbus Ambulatory Healthcare Services, Inc.

  • Family Medicine Physician
  • Phenix City, AL
  • NPI 1699240531
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)
• Mary M Feldman MD LLC

  dba Carrollton Dermatology

  • Medical Specialty Clinic/Center
  • Carrollton, GA
  • NPI 1699215541
  NPD (past)
• West Georgia Center for Diabetes and Endocrinology

  • Specialist
  • Carrollton, GA
  • NPI 1821116781
  NPD (past)

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1942328984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173921",
            "telephone_number": "678-796-0681",
            "fax_number": "770-836-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173921",
            "telephone_number": "678-796-0681",
            "fax_number": "770-836-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AUTUMN",
        "middle_name": "DEESE",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "1075178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Daniel
• Mayla Daniel
• Kenneth M. Danis, D.P.M.
• David L. Vautin, DMD, LLC
• David P. Hartley,M.D., P.C.
• Charles Hoyt Davis III, MD
• Jessica Paige Davis, LPC
• Lee Jefferson Davis, MA, LPC
• Richard Davis, M. D.
• Torris Jamarcus Davison, CPR, BLS

• Physician Assistant in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.