STACY C. DAVIS MD PC (NPI# 1295008498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295008498 |
| Entity Type | Organization |
| Organization Name | STACY C. DAVIS MD PC |
| Practice Address |
1450 Winter St Augusta GA 30904-4708 |
| Practice Telephone | 7063643371 |
| Mailing Telephone | 7063643371 |
| Enumeration Date | 2012-02-17 |
| Last Update Date | 2012-02-17 |
| Authorized Official Name | STACY C DAVIS (PHYSICIAN) |
| Authorized Official Telephone | 7063643371 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000742948 E | 05 |
| Street Address |
1450 WINTER ST |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-4708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386746378 | Stacy C. Davis | Pediatrics | 1450 Winter St, Augusta, GA 30904-4708 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134745953 | Molly C Shields | Pediatrics | Dugas Building Bg 107 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-17 |
| 1033734918 | Lauren Wooten Smith | Pediatrics | Chog Pediatric Residency Program 1120 15th Street, Augusta, GA 30912-0001 | 2020-06-16 |
| 1487211199 | Ashley Elizabeth Miller | Pediatrics | 1146 Harper Street, Augusta, GA 30912-0001 | 2019-05-29 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1558824797 | John-david Constantine Bruce | Pediatrics | Dugas Building (bg-1071) 1120 15th Street, Augusta, GA 30912-0001 | 2019-04-12 |
| 1306229182 | Alexander James Eason | Pediatrics | Georgia Regents Medical Ctr, 1120 15th Street, Augusta, GA 30912-0001 | 2015-06-30 |
| 1184945339 | Shannon Nicole Myers | Pediatrics | 3727 Executive Center Dr, Augusta, GA 30907-2398 | 2010-06-22 |
| 1801113386 | Gerard Rubin | Pediatrics | 6 E Chestnut St Ste 310, Augusta, ME 04330-5717 | 2010-04-23 |
| 1013246487 | William Weston IIi | Pediatrics | 93 Bristlecone Ct., Augusta, GA 30909-1861 | 2009-12-15 |
| 1225285372 | Mustafa Musa Nimir | Pediatrics | 1120 15th St Ae-3042, Medical College of Georgia, Augusta, GA 30912-5000 | 2008-08-20 |
| Find all providers in AUGUSTA | ||||
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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.