Larry D Davis Jr. is a Family Medicine Physician practicing in Janesville, Wisconsin. The National Provider Identifier (NPI) is #1245887728, which was assigned on August 20, 2019, and the registration record was last updated on February 4, 2025. The practitioner's main practice location is at 849 Kellogg Ave, Janesville, WI 53546-2808; the contact telephone number is 6087557960, and the fax number is 6087557873. The primary taxonomy of Larry D Davis Jr. is Family Medicine Physician (207Q00000X). Larry D Davis Jr. is licensed to practice in the state of Wisconsin (#8075-851), California (#A185596).
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
| NPI | 1245887728 |
| Entity Type | Individual |
| Provider Name | LARRY D DAVIS JR. |
| Other Name |
LARRY DEAN DAVIS (Other Name) |
| Gender | Male |
| Credential | MD |
| Other Credential | MD |
| Practice Address |
849 Kellogg Ave Janesville WI 53546-2808 |
| Practice Telephone | 6087557960 |
| Practice Fax Number | 6087557873 |
| Mailing Address |
849 Kellogg Ave Janesville WI 53546-2808 |
| Mailing Telephone | 6087557960 |
| Mailing Fax Number | 6087557873 |
| Certification Date | 2025-02-04 |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2025-02-04 |
| Is Sole Proprietor | N |
| PAC ID |
7618374828 Medicare Provider Enrollment and Chain/Ownership System (PECOS) Associate Control (PAC) ID |
| Full Name | LARRY D DAVIS |
| Primary Specialty | FAMILY PRACTICE |
| Organization Legal Name | SOUTHERN CALIFORNIA PERMANENTE MEDICAL GROUP |
| Address |
9961 Sierra Ave Fontana CA 92335-6720 |
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 8075-851 | WI | ||
| Y | 207Q00000X | Family Medicine | A185596 | CA |
| Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| Classification | Family Medicine |
| Grouping | Allopathic & Osteopathic Physicians |
| Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| Classification | Student in an Organized Health Care Education/Training Program |
| Grouping | Student, Health Care |
| Definition: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
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|---|---|---|---|
| Jordan Mills | 2836 Enterprise Rd, Debary, FL 32713-5210 | Family Medicine Physician | 2025-09-05 |
| Katrina Cochran | 1110 Sugar Hill Dr, Moncks Corner, SC 29461-6003 | Family Medicine Physician | 2025-09-06 |
| Madison Skye Belluccia | 497 Sand Broad Ct, Westerville, OH 43081-5075 | Family Medicine Physician | 2025-09-05 |
| Unknown Poonam | 701 E Rosser Ave, Bismarck, ND 58501-4457 | Family Medicine Physician | 2025-09-05 |
| Thrive Urgent & Wellness Center | 403 W Galena Blvd Ste 109, Aurora, IL 60506-3948 | Family Medicine Physician | 2025-09-05 |
| Naamah Leah Brocco | 7710 Mercy Rd Ste 202, Omaha, NE 68124-2353 | Family Medicine Physician | 2025-09-06 |
| Heart of Texas Community Health Center, Inc. | 409 W Adams Ave Ste 200, Temple, TX 76501-4211 | Family Medicine Physician | 2025-09-05 |
| Dawn Marie Bronico | 1206 Sullivan Trl, Easton, PA 18040-1353 | Family Medicine Physician | 2025-09-06 |
| Olympic Concierge Med, Inc. | 25200 Sawyer Francis Ln, Lutz, FL 33559-6947 | Family Medicine Physician | 2025-09-05 |
| Grace At Home | 2300 N St Nw Ste 200, Washington, DC 20037-1353 | Family Medicine Physician | 2025-09-05 |
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| Street Address |
849 KELLOGG AVE |
| City | JANESVILLE |
| State | WI |
| Zip Code | 53546-2808 |
| Country | US |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Michael Visher | 849 Kellogg Ave, Janesville, WI 53546-2808 | Student in an Organized Health Care Education/Training Program | 2025-04-29 |
| Sobia Khalil | 849 Kellogg Ave, Janesville, WI 53546-2808 | Family Medicine Physician | 2023-06-12 |
| Bryan Henriquez | 849 Kellogg Ave, Janesville, WI 53546-2808 | Student in an Organized Health Care Education/Training Program | 2025-04-04 |
| Aakash Oad | 849 Kellogg Ave, Janesville, WI 53546-2808 | Family Medicine Physician | 2025-06-02 |
| Meryum Ishrat Baig | 849 Kellogg Ave, Janesville, WI 53546-2808 | Student in an Organized Health Care Education/Training Program | 2024-11-26 |
| Fayyaz Ahmed | 849 Kellogg Ave, Janesville, WI 53546-2808 | Student in an Organized Health Care Education/Training Program | 2025-05-15 |
| Gilberto M Enriquez | 849 Kellogg Ave, Janesville, WI 53546-2808 | Family Medicine Physician | 2022-08-23 |
| Saad Mohsin | 849 Kellogg Ave, Janesville, WI 53546-2808 | Family Medicine Physician | 2016-12-06 |
| Navjot K. Sekhon | 849 Kellogg Ave, Janesville, WI 53546-2808 | Student in an Organized Health Care Education/Training Program | 2018-07-23 |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Caitlin J Turkowski | 3200 E Racine St, Janesville, WI 53546-2343 | Nurse Practitioner | 2025-01-15 |
| Kathryn Hockensmith | 3524 E Milwaukee St, Janesville, WI 53546-1626 | General Practice Physician | 2023-06-07 |
| Lauren Marie O'Brien · Lauren Marie Biernacki | 1407 N Wright Rd, Janesville, WI 53546-1314 | Dentist | 2020-06-03 |
| April H Garcia | 3200 E Racine St, Janesville, WI 53546-2343 | Psychiatric/Mental Health Nurse Practitioner | 2017-06-29 |
| Amy L Stella | 3200 E Racine St, Janesville, WI 53546-2343 | Hematology & Oncology Physician | 2006-10-04 |
| Nicole M Wieman | 3200 E Racine St, Janesville, WI 53546-2343 | Nurse Practitioner | 2014-02-06 |
| Mansour Shirzai | 3524 E Milwaukee St, Janesville, WI 53546-1626 | Student in an Organized Health Care Education/Training Program | 2023-06-08 |
| Leah Welch | 3524 E Milwaukee St, Janesville, WI 53546-1626 | Physical Therapist | 2025-06-16 |
| Jordan L Perry · Jordan L Johnson | 3200 E Racine St, Janesville, WI 53546-2343 | Physician Assistant | 2015-07-08 |
| Karlee Wilgenbusch | 500 Midland Ct, Janesville, WI 53546-2341 | Physician Assistant | 2021-01-14 |
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| Dean Larry Jensen Sr. | 1989 Pass Rd, Biloxi, MS 39531-4103 | Mental Health Counselor | 2025-07-14 |
| Larry J Little | 8383 N Davis Hwy, Pensacola, FL 32514-6039 | Certified Registered Nurse Anesthetist | 2006-06-13 |
| Larry Thomas Balentine · Larry Balentine | 259 Hunt Rd, Port Angeles, WA 98363-9657 | Rheumatology Physician | 2006-10-03 |
| Larry Yap Ong | 2401 N Shepherd Dr Ste A130, Houston, TX 77008-2990 | Family Nurse Practitioner | 2019-04-05 |
| Franklin Elvadie Davis III · Trey Davis | 3690 Grandview Pkwy, Birmingham, AL 35243-3326 | Student in an Organized Health Care Education/Training Program | 2025-05-07 |
| William Brennan Davis · Bren Davis | 840 Walnut St Ste 1230, Philadelphia, PA 19107-5109 | Ophthalmology Physician | 2020-03-25 |
| Larry Yin | 2401 S 31st St # Ms 01161b, Temple, TX 76508-0001 | Student in an Organized Health Care Education/Training Program | 2025-03-27 |
| Otis Mckinnley Davis Iv · Braeden Davis | 4301 W Markham St # 634, Little Rock, AR 72205-7101 | Student in an Organized Health Care Education/Training Program | 2025-03-31 |
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This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid). Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008. This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information. |