Active NPI
Patricia C Davis, M.D.
- Diagnostic Radiology Physician
- Atlanta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 019928
- Practice address
- 1000 Johnson Ferry Rd
Atlanta, GA 30342 - Phone
- (404) 851-6323
- Fax
- (404) 303-3747
- NPI assigned
- Dec 9, 2005
- Last updated
- May 3, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuroradiology Physician | 2085N0700X | 019928 | GA | |
| Diagnostic Radiology Physician | 2085R0202X | 019928 | GA | Primary |
Addresses
Primary practice location
1000 Johnson Ferry Rd
Atlanta, GA 30342
Mailing address
5605 Glenridge Dr Ste 325
Atlanta, GA 30342-1365
Phone (678) 553-7783
Other practice location 1
3193 Howell Mill Rd NW
Suite 110
Atlanta, GA 30327-2119
Phone (404) 355-7591
Other practice location 2
3193 Howell Mill Rd NW
Suite 110
Atlanta, GA 30327-2119
Phone (404) 355-7591
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202G708830 | Other | GA | RAILROAD MEDICARE |
| 000244054AB | Medicaid | GA | |
| 300135706 | Other | GA | RAILROAD MEDICARE |
| 000244054C | Medicaid | GA | |
| 300135705 | Other | GA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019928 | GA | MD | Neuroradiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoebe Putney Memorial Hospital Inc | Current | Accepting new patients | |
| Open MRI of Georgia, LLC | Diagnostic Radiology | Past | Accepting new patients |
Locations
2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802
417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207
500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802
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.
-
dba Phoebe Putney Memorial Hosptial
- General Acute Care Hospital
- Albany, GA
- NPI 1992789721
-
dba Johns Creek Diagnostic Center
- Diagnostic Radiology Physician
- Suwanee, GA
- NPI 1669875902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556841600000",
"number": "1982689204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5605 GLENRIDGE DR STE 325",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421365",
"telephone_number": "678-553-7783",
"fax_number": "678-553-7794"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 JOHNSON FERRY RD",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30342",
"telephone_number": "404-851-6323",
"fax_number": "404-303-3747"
}
],
"practiceLocations": [
{
"address_1": "3193 Howell Mill Rd NW",
"address_2": "Suite 110",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303272119",
"country_code": "US",
"telephone_number": "404-355-7591",
"fax_number": "404-355-9175",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3193 Howell Mill Rd NW",
"address_2": "Suite 110",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303272119",
"country_code": "US",
"telephone_number": "404-355-7591",
"fax_number": "404-355-9175",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "PATRICIA",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-09",
"last_updated": "2019-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "GA",
"license": "019928",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "GA",
"license": "019928",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "202G708830",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000244054AB",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300135706",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000244054C",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "300135705",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.