Individual provider Active NPI

Donen Davis, M.D.

  • Plastic Surgery Physician
  • Columbia, SC
National Provider Identifier
1972509925
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
21726 Issued in SC
Practice address
1850 Laurel St
Ste B
Columbia, SC 29201-2627
Phone
(803) 929-1901
Fax
(803) 929-1916
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 21726 SC Primary

Addresses

Primary practice location

1850 Laurel St
Ste B
Columbia, SC 29201-2627

Mailing address

1850 Laurel St
Ste B
Columbia, SC 29201-2627
Phone (803) 929-1901

Other identifiers 1

IdentifierTypeStateIssuer
GP3919MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040610000540 SC Practitioner - Plastic and Reconstructive Surgery 7416930557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Medical University of South Carolina College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1850 Laurel St
Suite B
Columbia, SC 29201-2658
Phone (803) 929-1901

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21726SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Donen Davis Plastic Surgery, LLC Plastic Surgery CurrentSince Jun 1, 2004 Accepting new patients
Carolina Interventional Pain Institute, LLC Past Accepting new patients

Locations

1850 Laurel St
Columbia, SC 29201
Phone (803) 256-3400

1850 Laurel St
Ste B
Columbia, SC 29201
Phone (803) 929-1901

Interoperability endpoints

  • Direct secure messaging: ddavis380449@direct.musc.edu
  • FHIR API: https://api.platform.athenahealth.com/17099/brand/4/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1972509925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 LAUREL ST",
            "address_2": "STE B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012627",
            "telephone_number": "803-929-1901",
            "fax_number": "803-929-1916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 LAUREL ST",
            "address_2": "STE B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012627",
            "telephone_number": "803-929-1901",
            "fax_number": "803-929-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DONEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "SC",
            "license": "21726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3919",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.