Individual provider Active NPI

Melissa S Davis, M.D.

  • Family Medicine Physician
  • Lexington, KY
National Provider Identifier
1972574978
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30210 Issued in KY
Practice address
2250 Leestown Rd
Lexington, KY 40511-1052
Phone
(859) 233-4511
NPI assigned
Jan 28, 2006
Last updated
Feb 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30210 KY Primary

Addresses

Primary practice location

2250 Leestown Rd
Lexington, KY 40511-1052

Mailing address

1157 Taborlake Walk
Lexington, KY 40502-7719
Phone (606) 571-3419

Other identifiers 3

IdentifierTypeStateIssuer
000000374866OtherBLUE CROSS AND BLUE SHIELD
64095722MedicaidKY
000000578808OtherBLUE CROSS AND BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20220429001150 KY Order and Referring Only - Family PracticePractitioner - Family Practice 6204881485

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30210KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ashland Family Medicine Family Medicine Past Accepting new patients
Dr. Melissa Davis, P.S.C. Family Medicine Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1972574978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 TABORLAKE WALK",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405027719",
            "telephone_number": "606-571-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 LEESTOWN RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111052",
            "telephone_number": "859-233-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MELISSA",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-28",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "30210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "000000374866",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64095722",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "000000578808",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.