Individual provider Active NPI

Raemarie Johnson Davis, PA-C

  • Physician Assistant
  • Newport News, VA
National Provider Identifier
1992142962
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-004251 Issued in VA
Practice address
12997 Warwick Blvd
Newport News, VA 23602-8352
Phone
(757) 369-3357
NPI assigned
May 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110-004251 VA Primary

Addresses

Primary practice location

12997 Warwick Blvd
Newport News, VA 23602-8352

Mailing address

12997 Warwick Blvd
Newport News, VA 23602-8352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141223001613 VA Practitioner - Physician Assistant 4880814466 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michumi PLLCGroup PAC ID 5193784395, 40 clinicians

Practice addresses (Care Compare)

120 Monticello Ave
Williamsburg, VA 23185-2840
Phone (757) 564-3627

12997 Warwick Blvd
Newport News, VA 23602-8352
Phone (757) 369-9446

6567 George Washington Memorial Hwy
Gloucester, VA 23061-3754
Phone (804) 824-9962

Merit-based Incentive Payment System (MIPS)

Final score
81.91 of 100Reported as group
Quality
78.72
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110-004251VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Williamsburg Emergency Physicians CurrentSince Sep 1, 2019 Accepting new patients
Tidewater Physicians Multispecialty Group PC PastSince Apr 1, 2005 Accepting new patients
Tidewater Physicians Multispecialty Group PC Past Accepting new patients
Peninsula Radiological Associates Limited Past Accepting new patients

Locations

100 Sentara Cir
Williamsburg, VA 23188
Phone (678) 690-7826

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD
  • Direct secure messaging: rdavis26050@direct.rivhs.com

Organizations & group practices 6

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": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1992142962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12997 WARWICK BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236028352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12997 WARWICK BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236028352",
            "telephone_number": "757-369-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RAEMARIE",
        "middle_name": "JOHNSON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-004251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.