JARED DAVIS (NPI# 1114459476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114459476 |
| Entity Type | Individual |
| Full Name | JARED DAVIS |
| Credential | D.O. |
| Practice Address |
1000 Harrington St Mount Clemens MI 48043 |
| Mailing Address |
1000 Harrington Boulevard Mount Clemens MI 48043 |
| Practice Telephone | 5864938000 |
| Mailing Fax Number | 5864933250 |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2018-06-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 5101023055 | MI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659925972 | Jared Davis | Physical Therapist | 541 Historic Hiwy 441, Demorest, GA 30535 | 2019-07-25 |
| 1528384195 | Jared Michael Davis | Surgery | 1019 Rosemary Dr, Louisville, KY 40213-1119 | 2010-04-08 |
| 1922234699 | Jared Andrew Davis | Anesthesiology | 70 Medical Center Circle, Suite 305, Fishersville, VA 22939-0000 | 2009-06-08 |
| 1891938684 | Jared Davis | Internal Medicine | 6179 S Balsam Way Ste 210, Littleton, CO 80123-3093 | 2009-04-09 |
| 1235783374 | Jared Myles Davis | Counselor | 661 Madison Ave, Memphis, TN 38103-3307 | 2019-07-26 |
| 1518493998 | Jared M Davis | Physician Assistant | 2863 Highway 45 Byp, Jackson, TN 38305-3618 | 2017-05-04 |
| 1518404680 | Jared Davis | Counselor | 1900 Grand Ave N Ste A, Spencer, IA 51301-2200 | 2017-01-26 |
| 1942664263 | Jared William Davis | Student in an Organized Health Care Education/Training Program | 625 19th St S, Birmingham, AL 35233-1900 | 2016-04-12 |
| 1487095659 | Jared Davis | Psychiatry & Neurology | 5841 S Maryland Ave # Mc2030, Chicago, IL 60637-1447 | 2013-07-16 |
| 1942530399 | Jared D Davis | Chiropractor | 1054 E Main St, Cottage Grove, OR 97424-2230 | 2010-01-07 |
| Street Address |
1000 HARRINGTON ST |
| City | MOUNT CLEMENS |
| State | MI |
| Zip Code | 48043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255336335 | Richard L Reece Jr. | Internal Medicine | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2005-06-16 |
| 1033710116 | Mclaren Macomb | Rehabilitation Unit | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-11-04 |
| 1477154060 | Michael Dennie | Nurse Practitioner | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-11-02 |
| 1144828088 | Micayla Wehby | Nurse Practitioner | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-10-13 |
| 1326650516 | Dawn Miller | Social Worker | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-08-19 |
| 1437760246 | Sandeep Kaur | Internal Medicine | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-08-14 |
| 1538779475 | Kirandeep Sehmi | Internal Medicine | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-08-05 |
| 1669080172 | Anisha Tailor | Internal Medicine | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-07-21 |
| 1518575448 | Duncan George Innes | Family Medicine | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-07-16 |
| 1851909790 | John Murray | Family Medicine | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2020-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699300228 | Blue Diamond Aba Services LLC | Assistant Behavior Analyst | 102 North Avenue, Mt. Clemens, MI 48043 | 2020-03-04 |
| 1265086136 | Venture Counseling | Social Worker | 198 S. Main Street, Suite 2, Mount Clemens, MI 48043 | 2019-07-30 |
| 1386203651 | Michele Lee Casebolt | Physical Therapist | 30795 Twenty Three Mile Rd., Chesterfield, MI 48043 | 2019-06-11 |
| 1730669706 | Wynn A Mitchell | Case Manager/Care Coordinator | 24 Hubbard St, Mount Clemens, MI 48043 | 2018-08-18 |
| 1629520101 | Boitshoko Marang | Family Medicine | Clinton River Drive 11a, Mount Clemens, MI 48043 | 2016-10-31 |
| 1720332265 | New Passages | Point of Service | 175 N. Grorsebeck Hwy, Mt. Clemens, MI 48043 | 2012-11-06 |
| 1376807784 | Christopher John Shamass | Emergency Medicine | 1000 Harrington Boulevard, Mount Clemens, MI 48043 | 2012-06-29 |
| 1265749683 | Mycare Health Center | Clinic/Center | 18 Market Street, Suite C, Mount Clemens, MI 48043 | 2010-09-07 |
| 1114102837 | George Edward Perron | Family Medicine | 256 Wellington Crescent, Mt Clemens, MI 48043 | 2007-12-31 |
| 1558568733 | Dawood Ghassan Dalaly | Surgery | 1000 Harrington, Mt Clemens, MI 48043 | 2007-06-29 |
| Find all providers in zip 48043 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316442874 | Anthony Bonzagni | Urology | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2018-03-27 |
| 1326570466 | Chase Tyler Cavayero | Urology | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2017-03-29 |
| 1154771285 | Hailey Sam Eisner | Urology | 1000 Harrington St, Mount Clemens, MI 48043-2920 | 2016-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477488 | Munson Healthcare Charlevoix Hospital | Urology | 11695 Park Ave, Suite A, Charlevoix, MI 49720 | 2020-11-06 |
| 1396235610 | Munson Medical Center | Urology | 405 N Division Rd Ste 2, Petoskey, MI 49770-9046 | 2018-05-11 |
| 1770072498 | Bellin Health Iron Mountain Inc | Urology | 1005 S Hemlock St Ste B, Iron Mountain, MI 49801-3854 | 2018-05-08 |
| 1205215621 | Alexander David Tapper | Urology | 44200 Woodward Ave Ste 207, Pontiac, MI 48341-5045 | 2015-05-19 |
| 1912324211 | Boston Medical Group, P.C. | Urology | 24901 Northwestern Hwy., Suite 615, Southfield, MI 48075 | 2014-03-25 |
| 1548600984 | Katie Marie Rosen | Urology | 19991 Hall Rd Ste 201, Macomb, MI 48044 | 2013-06-30 |
| 1609213636 | Arya Khatiwoda | Urology | 2900 Hannah Blvd Ste 104, East Lansing, MI 48823-5380 | 2013-05-31 |
| 1003179730 | Kalen Jacob Rimar | Urology | 130 Town Center Dr Ste 101, Troy, MI 48084 | 2012-06-18 |
| 1780955294 | Harry Nicholas Kotsis | Urology | 265 Touraine Rd, Grosse Pointe Farms, MI 48236-3308 | 2012-01-16 |
| 1750678264 | Michael Kozminski | Urology | 245 Cherry St Se Ste 202, Grand Rapids, MI 49503-4607 | 2011-07-05 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT CLEMENS |
| Zip Code | 48043 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.