Deactivated NPI 1013078179 Deactivated / Inactive NPI Male Practitioner

Dr. Robert Glenn Davis , MD

Internal Medicine - Nephrology • Jacksonville, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Robert Davis has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 13, 2006

NPI Deactivation Date September 07, 2021

Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Davis, MD was a registered Internal Medicine - Nephrology practicing in Jacksonville, FL. Throughout an active medical career spanning 15 years, Dr. Davis provided care at the practice location at 3129 HENDRICKS AVENUE until profile deactivation on 2021-09-07.

Historical Medicare Part B clinical services included established patient outpatient office visit, subsequent hospital care with moderate levelof medical decision making, if using time, at least, dialysis services. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

3129 Hendricks Avenue

Jacksonville, FL 322074217

Telephone 9043988266

Fax 9043964803

Associated Practice Facility / Clinic

🏢 Louis F Gregory And R Glenn Davis Facility NPI 1699836767

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine - Nephrology in Jacksonville, FL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 22.3 Yrs

State Avg: 28.0 Yrs

Regional Practice Density

81 Specialists

Practicing in Jacksonville, FL (865 Statewide)

Telehealth Adoption Rate

40.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

38.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	29	29	$207.00	$127.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	330	195	$275.00	$137.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	76	73	$207.00	$104.98

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	415	215	$275.00	$142.72
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	335	112	$193.08	$104.09
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	296	111	$650.00	$282.14
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	103	90	$207.00	$106.90
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	42	37	$299.83	$203.06
90945 Dialysis procedure including 1 evaluation	38	15	$159.00	$85.66
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	24	24	$500.00	$238.41
90966 Home dialysis services per month, patient 20 years of age or older	19	19	$475.00	$237.60
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	19	19	$410.00	$205.96
90935 Hemodialysis procedure with physician evaluation	18	18	$144.00	$73.71
99213 Established patient office or other outpatient visit, typically 15 minutes	11	11	$135.00	$73.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	438	133	$194.00	$99.24
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	435	245	$275.00	$137.94
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	326	129	$650.00	$270.82
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	112	99	$207.00	$102.00
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	71	55	$359.32	$195.64
90935 Hemodialysis procedure with physician evaluation	60	31	$144.00	$70.37
90966 Home dialysis services per month, patient 20 years of age or older	55	26	$475.00	$225.17
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	41	39	$500.00	$229.64
99213 Established patient office or other outpatient visit, typically 15 minutes	29	29	$135.00	$67.71
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	16	16	$410.00	$198.88
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	13	11	$275.00	$106.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	552	293	$275.00	$136.70
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	545	147	$194.00	$101.46
90960 Dialysis services, 4 or more physician visits per month (20 years or older)	299	118	$650.00	$273.63
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	94	80	$378.00	$197.30
90961 Dialysis services, 2-3 physician visits per month (20 years or older)	59	52	$500.00	$229.75
90935 Hemodialysis procedure with physician evaluation	51	36	$144.00	$70.08
90966 Home dialysis services per month, patient 20 years of age or older	47	31	$475.00	$224.39
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	30	30	$410.00	$199.78
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	29	29	$209.34	$100.30
99213 Established patient office or other outpatient visit, typically 15 minutes	13	12	$135.00	$69.83

Medical Specialties & State Licenses

Internal Medicine - Nephrology Primary Specialty

NUCC Taxonomy Code: 207RN0300X

State License FL ME32664

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners

Dr. Andrew Wasiluk , MD

Internal Medicine - Nephrology

NPI 1457455719

Doctor of Medicine (M.D.)

Dr. Louis Gregory , MD

Internal Medicine - Nephrology

NPI 1669576732

Doctor of Medicine (M.D.)

Dr. Hem Chataut , MD

Internal Medicine - Nephrology

NPI 1871800763

Doctor of Medicine (M.D.)

Roy Crumley-Forest , ARNP

Nurse Practitioner

NPI 1912095233

Advanced Registered Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

⚠️

NPI Profile Deactivated September 07, 2021

Record deactivated on September 07, 2021

✅

NPI Profile Active November 03, 2009

NPI status registered as active in NPPES database

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Updated Practice Location November 03, 2009

Registered at 3129 HENDRICKS AVENUE, JACKSONVILLE, FL 322074217 (Tel: 9043988266)

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Updated Business Mailing Address November 03, 2009

Registered at 3129 HENDRICKS AVENUE, JACKSONVILLE, FL 322074217 (Tel: 9043988266)

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Provider Name / Credentials Updated November 03, 2009

Recorded as ROBERT DAVIS, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 03, 2009

Internal Medicine (License #ME32664 in FL)

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Initial NPI Registration & Enumeration December 13, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1013078179

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: December 13, 2006

Last Update: November 03, 2009

Deactivation Date: September 07, 2021

Update or Correct Profile

Mailing Address

3129 Hendricks Avenue

Jacksonville, FL 322074217

Phone: 9043988266

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.