Individual provider Active NPI

Wellington Joseph Davis III, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Allentown, PA
National Provider Identifier
1982813853
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
MD432065 Issued in PA
Practice address
1210 S Cedar Crest Blvd Ste 100
Allentown, PA 18103-6229
Phone
(610) 402-7999
Fax
(610) 402-7995
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 036-109354 IL
Plastic and Reconstructive Surgery Physician 2086S0122X MD432065 PA Primary

Addresses

Primary practice location

1210 S Cedar Crest Blvd Ste 100
Allentown, PA 18103-6229

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070809000275 PA Practitioner - Plastic and Reconstructive SurgeryPractitioner - General Surgery 8426149170 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive SurgeryAlso: General Surgery
Education
Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1210 S Cedar Crest Blvd
110 LVPG Pediatric Surgical Specialties
Allentown, PA 18103-6229
Phone (610) 402-7999

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-109354ILMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Oct 7, 2019 Accepting new patients
STC Pediatrics LLC Current Accepting new patients
STC Pediatrics LLC CurrentSince Dec 1, 2019 Accepting new patients
STC Pediatrics LLC CurrentSince Dec 1, 2019 Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 7, 2019 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Pulmonary Associates PC Past Accepting new patients
Lehigh Valley Hospital Past Accepting new patients
Apple Drugs Inc Past Accepting new patients

Locations

400 N 17th St
Ste 207
Allentown, PA 18104
Phone (610) 402-2810

1210 S Cedar Crest Blvd
Ste 100
Allentown, PA 18103
Phone (610) 402-7999

1210 S Cedar Crest Blvd
Ste 1100
Allentown, PA 18103
Phone (610) 402-7999

1210 S Cedar Crest Blvd
Ste 110
Allentown, PA 18103
Phone (610) 402-7999

153 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 526-3200

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

3701 Corriere Rd
Ste 10
Palmer Township, PA 18045
Phone (484) 591-7060

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-4067

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

320 W Pumping Station Rd
Ste 4
Quakertown, PA 18951
Phone (215) 529-4270

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1982813853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 S CEDAR CREST BLVD STE 100",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036229",
            "telephone_number": "610-402-7999",
            "fax_number": "610-402-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WELLINGTON",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": "036-109354",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "PA",
            "license": "MD432065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.