NPIMap

Individual provider Active NPI

Jared William Davis, MD

  • Interventional Cardiology Physician
  • Thomasville, GA
National Provider Identifier
1942664263
Registry record updated Jun 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
95298 Issued in GA
Practice address
116 Mimosa Dr
Thomasville, GA 31792-6605
Phone
(229) 584-5570
NPI assigned
Apr 12, 2016
Last updated
Jun 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 95298 GA Primary

Addresses

Primary practice location

116 Mimosa Dr
Thomasville, GA 31792-6605

Mailing address

625 19TH St S
Birmingham, AL 35233-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20230721000178 GA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8921396219 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Florida State University College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CCSG, IncGroup PAC ID 6103130745, 25 clinicians

Practice addresses (Care Compare)

915 Gordon Ave
Thomasville, GA 31792-6614
Phone (229) 228-2000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting54
Pacemaker insertion or repair17
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Grady General Hospital CurrentSince Jul 1, 2023 Accepting new patients
John D Archbold Memorial Hospital Inc CurrentSince Jul 1, 2023 Accepting new patients
CCSG, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Brooks County Hospital CurrentSince Jul 1, 2023 Accepting new patients
Pathology Associates, P.C. Current Accepting new patients
Hospital Authority of Mitchell County CurrentSince Jul 1, 2023 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

1323 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-0283

1500 E Shotwell St
Bainbridge, GA 39819
Phone (229) 243-6100

1155 5th St SE
Cairo, GA 39828
Phone (229) 226-3060

259 US Highway 19 N
Camilla, GA 31730
Phone (229) 227-1229

90 E Stephens St
Camilla, GA 31730
Phone (229) 200-4950

1 Sweet Bay Ct
Moultrie, GA 31768
Phone (229) 890-5305

3131 Thomasville Hwy
Moultrie, GA 31768
Phone (229) 502-9769

1309 W Screven St
Quitman, GA 31643
Phone (229) 263-6992

903 N Court St
Quitman, GA 31643
Phone (229) 263-4531

100 Mimosa Dr
Thomasville, GA 31792
Phone (229) 226-9141

116 Mimosa Dr
Thomasville, GA 31792
Phone (229) 551-0083

900 Cairo Rd
Thomasville, GA 31792
Phone (229) 227-5102

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

920 Cairo Rd
Thomasville, GA 31792
Phone (229) 228-8800

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/66097e3b-7cef-4b96-acca-38bfaae85903/

Organizations & group practices 7

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 8

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": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1942664263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MIMOSA DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926605",
            "telephone_number": "229-584-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JARED",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-12",
        "last_updated": "2023-06-21",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "95298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

Verify at the official NPI Registry.