Individual provider Active NPI

Demetrice Sharnae Davis, M.D.

  • Diagnostic Radiology Physician
  • Edina, MN
National Provider Identifier
1962710780
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
14415 Issued in NV
Practice address
3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone
(952) 595-1301
NPI assigned
Sep 14, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 92688 GA
Diagnostic Radiology Physician 2085R0202X 14415 NV Primary
Diagnostic Radiology Physician 2085R0202X E-16415 AR

Addresses

Primary practice location

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915

Mailing address

3600 Minnesota Dr Ste 800
Edina, MN 55435-7915
Phone (952) 595-1301

Other practice location 1

1 Independence Pt Ste 202
Greenville, SC 29615-4536
Phone (877) 406-2916

Other practice location 2

7130 Smoke Ranch Rd Ste 101
Las Vegas, NV 89128-3157
Phone (702) 942-4117

Other practice location 3

4301 W Markham St # 556
Little Rock, AR 72205-7101
Phone (501) 296-1095

Other identifiers 2

IdentifierTypeStateIssuer
1962710780MedicaidNV
P00113844OtherNVRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA, AR, VT4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20120806000692 NV Practitioner - Diagnostic Radiology 0446406573 Reassigns benefits to 20 organizations
I20221213001265 CA Practitioner - Diagnostic Radiology 0446406573 Reassigns benefits to 11 organizations
I20230706004017 AR Practitioner - Diagnostic Radiology 0446406573 Reassigns benefits to 4 organizations
I20240322001766 VT Practitioner - Diagnostic Radiology 0446406573 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Radiology Specialists LTD Marasso-MillerGroup PAC ID 0143110874, 136 clinicians
San Antonio Radiological MedicalGroup PAC ID 8325035942, 54 clinicians

Practice addresses (Care Compare)

3100 N Tenaya Way
Las Vegas, NV 89128-0436
Phone (866) 722-1655

3186 S Maryland Pkwy
Las Vegas, NV 89109-2317
Phone (866) 722-1655

6028 Downs CT
Las Vegas, NV 89149-5108
Phone (952) 595-1100

Hospital & facility affiliations

  • Calverthealth Medical Center Hospital, Prince Frederick, MD, CCN 210039
  • King'S Daughters' Medical Center Hospital, Ashland, KY, CCN 180009
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • Mountainview Hospital Hospital, Las Vegas, NV, CCN 290039
  • Wellspan York Hospital Hospital, York, PA, CCN 390046

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14415NVMDPharmacist
92688GAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Arkansas for Medical Sciences Family Medicine CurrentSince Jun 1, 2023 Accepting new patients
Silicon Valley Diagnostic Imaging, Inc. Diagnostic Radiology CurrentSince Oct 1, 2022 Accepting new patients
X-Ray Medical Group Inc Diagnostic Radiology CurrentSince Dec 1, 2022 Accepting new patients
County of San Joaquin CurrentSince Sep 13, 2022 Accepting new patients
County of San Joaquin CurrentSince Sep 13, 2022 Accepting new patients
Casa Colina Hospital and Centers for Healthcare Current Accepting new patients
Arkansas Health Group CurrentSince Dec 1, 2024 Accepting new patients
Oklahoma Radiology Group P C Diagnostic Radiology CurrentSince Jan 21, 2024 Accepting new patients
Mountain Communities Healthcare District Current Accepting new patients
Fullerton Radiology Medical Group, Inc Diagnostic Radiology CurrentSince Oct 12, 2022 Accepting new patients
Adventist Health Medical Center Tehachapi Current Accepting new patients
County of Santa Clara CurrentSince Jan 11, 2023 Accepting new patients
San Joaquin Faculty Medical Group CurrentSince Sep 13, 2022 Accepting new patients
West Valley Radiology Medical Group, Inc. Diagnostic Radiology CurrentSince May 19, 2024 Accepting new patients
Barden Thorwarth Daughtridge LTD Diagnostic Radiology CurrentSince May 1, 2023 Accepting new patients
County of Santa Clara CurrentSince Jan 11, 2023 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jun 1, 2023 Accepting new patients
Golding Radiology, LTD Diagnostic Radiology CurrentSince Sep 1, 2022 Accepting new patients
X-Ray Associates of Louisville PSC Diagnostic Radiology CurrentSince Jun 18, 2023 Accepting new patients
County of Santa Clara Family Medicine Current Accepting new patients
Carlos G. Otis Health Care Center Inc. Current Accepting new patients
Radiology Consultants of Little Rock, PA Diagnostic Radiology CurrentSince Oct 1, 2023 Accepting new patients
County of Santa Clara CurrentSince Jan 11, 2023 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Jun 1, 2023 Accepting new patients
Radx Imaging Partners Inc Diagnostic Radiology CurrentSince Apr 22, 2024 Accepting new patients
Virtual Radiologic Professionals, LLC Diagnostic Radiology CurrentSince May 1, 2024 Accepting new patients
Radiology Specialists LTD Marasso-Miller Diagnostic Radiology CurrentSince Aug 1, 2012 Accepting new patients
I V Radiology Medical Group Diagnostic Radiology CurrentSince Aug 1, 2022 Accepting new patients
Mountain Communities Healthcare District CurrentSince Apr 1, 2023 Accepting new patients
San Joaquin Community Hospital CurrentSince Jan 20, 2024 Accepting new patients
San Joaquin Community Hospital CurrentSince Jan 20, 2024 Accepting new patients
County of Santa Clara Current Accepting new patients
Adventist Health Medical Center Tehachapi CurrentSince Nov 12, 2023 Accepting new patients
Los Alamitos Radiology Group Inc Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients
University of Arkansas for Medical Sciences Family Medicine Current Accepting new patients
San Antonio Radiological Medical Diagnostic Radiology CurrentSince Nov 1, 2022 Accepting new patients
Professional Radiology Inc. Diagnostic Radiology CurrentSince Apr 1, 2023 Accepting new patients
County of Santa Clara CurrentSince Jan 11, 2023 Accepting new patients
Butler Imaging and Interventional Associates LLC Diagnostic Radiology CurrentSince Jul 3, 2023 Accepting new patients
Mountain Communities Healthcare District CurrentSince Apr 1, 2023 Accepting new patients
University of Arkansas for Medical Sciences Diagnostic Radiology Current Accepting new patients
Red River Consultants, Inc Diagnostic Radiology CurrentSince Apr 9, 2024 Accepting new patients
Carlos G Otis Health Care Center Inc Current Accepting new patients
Arkansas Health Group Diagnostic Radiology CurrentSince Dec 1, 2024 Accepting new patients
Focus Medical Imaging Diagnostic Radiology CurrentSince Jan 29, 2024 Accepting new patients
Claremont Imaging Associates, a Medical Corporation Diagnostic Radiology CurrentSince Jun 17, 2024 Accepting new patients
Carlos G Otis Health Care Center Inc CurrentSince May 1, 2024 Accepting new patients
Adventist Health Physicians Network Past Accepting new patients
Focus Medical Imaging Diagnostic Radiology Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients

Locations (25 of 55)

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

9601 Baptist Health Dr
Ste 1100
Little Rock, AR 72205
Phone (501) 748-3210

11001 Executive Center Dr
Ste 200C
Little Rock, AR 72211
Phone (501) 812-7587

1 Childrens Way
Ste 653
Little Rock, AR 72202

4301 W Markham St
#556
Little Rock, AR 72205
Phone (501) 296-1095

5528 E La Palma Ave
Ste 4A
Anaheim, CA 92807
Phone (714) 970-0200

2615 Chester Ave
Bakersfield, CA 93301
Phone (661) 381-7545

9602 Stockdale Hwy
Bakersfield, CA 93311
Phone (661) 633-5000

207 W Legion Rd
Brawley, CA 92227
Phone (760) 351-3333

9350 N Loop Blvd
California City, CA 93505
Phone (760) 373-1785

5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

10601 Walker St
Ste 150
Cypress, CA 90630
Phone (714) 656-2130

16465 Sierra Lakes Pkwy
Fontana, CA 92336
Phone (909) 244-9593

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

3751 Katella Ave
Los Alamitos, CA 90720
Phone (562) 799-3160

3801 Katella Ave
Ste 207
Los Alamitos, CA 90720
Phone (562) 598-9745

815 Pollard Rd
Los Gatos, CA 95032
Phone (408) 378-6131

323 S Heliotrope Ave
Monrovia, CA 91016
Phone (626) 408-9800

5000 San Bernardino St
Montclair, CA 91763
Phone (909) 625-4111

Interoperability endpoints

  • Direct secure messaging: casacolina@direct.casacolina.org

Organizations & group practices 51

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 51

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": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1962710780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 MINNESOTA DR STE 800",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554357915",
            "telephone_number": "952-595-1301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Independence Pt Ste 202",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296154536",
            "country_code": "US",
            "telephone_number": "877-406-2916",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7130 Smoke Ranch Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891283157",
            "country_code": "US",
            "telephone_number": "702-942-4117",
            "fax_number": "864-987-1611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4301 W Markham St # 556",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-296-1095",
            "fax_number": "501-526-5919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DEMETRICE",
        "middle_name": "SHARNAE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-14",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "92688",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NV",
            "license": "14415",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "E-16415",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962710780",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00113844",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

Verify at the official NPI Registry.