NPI age
20 years
Enumerated 2006-06-08
● Active
Type 1 · Individual
Tish D Davis, PA-C
Davis is 1 of 43 medical (physician assistant) providers in Meridian and 1 of 398 in Idaho.
Primary specialty
Medical (Physician Assistant)
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2019-07-22
Source: CMS NPPES provider record
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 398 active medical (physician assistant) providers in Idaho.
NPI age
20 years
↑ 5 yr above median (15 yr)
State licenses
1 state
16% of peers hold multiple states
Subspecialties
0
29% of peers hold subspecialties
NPI lifetime · 2006 → 2019
2006-06Enumerated in NPPES
2006
2019
Where they practice
Practice location
2235 E Gala St
Meridian, ID 836428026
Mailing address
425 W Bannock St
Boise, ID 837026035
Additional practice locations
3 secondary locations on file with NPPES.
Location 2
425 W Bannock St
Boise, ID 837026035
Location 3
9850 St Lukes Dr
Nampa, ID 836877912
Location 4
1200 Garrity Blvd
Nampa, ID 836873402
Specialties
-
Physician Assistant PrimaryCMS NPPES uses NUCC taxonomy code 363AM0700X for provider records classified as Medical within Physician Assistant. The taxonomy identifies the category reported on the NPI record; it does not by itself verify services offered, current...
Medicare directory context
Medicare specialties
Physician Assistant
Largest Medicare group
33 members
Largest listed enrollment group
Facility affiliations reported by CMS
- Idaho Gastroenterology Associates Llp
Practice context
Part of a multi-provider practice. 14 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.