Keith E Davis, MD is a medicare enrolled "Family Medicine" physician in Shoshone, Idaho. His current practice location is
113 S Apple St, Shoshone, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 886-2224.
Keith E Davis is licensed to practice in Idaho (license number M4888) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1043277635.
Physician's Profile
| Full Name | Keith E Davis |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 113 S Apple St, Shoshone, Idaho |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1043277635
- Provider Enumeration Date: 04/27/2006
- Last Update Date: 11/15/2010
Medicare PECOS Information:
- PECOS PAC ID: 2668384702
- Enrollment ID: I20031118000654
Medical Identifiers
Medical identifiers for Keith E Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043277635 | NPI | - | NPPES |
| 001801000 | Medicaid | ID | |
| 133841 | Other | | RHC |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | M4888 (Idaho) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Keith E Davis allows following entities to bill medicare on his behalf.
| Entity Name | Family Health Services Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1033165550
PECOS PAC ID: 7012815038
Enrollment ID: O20040216000531 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Keith E Davis is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Keith E Davis, MD
113 S. Apple St., Po Box 609,
Shoshone, ID 83352-0609
Ph: (208) 886-2224 | Keith E Davis, MD
113 S Apple St,
Shoshone, ID 83352-5287
Ph: (208) 886-2224 |
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