SAMUEL WAYNE DAVIS (MD) – Family Medicine Physician, NPI 1336407758

SAMUEL WAYNE DAVIS (MD) is a healthcare provider. based in Evans, Colorado. specializing in FAMILY PRACTICE, OBSTETRICS/GYNECOLOGY. They hold the professional credentials MD. They hold a License No. 52933 (CO). The NPI Number for SAMUEL WAYNE DAVIS (MD) is 1336407758

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
SAMUEL WAYNE DAVIS (MD)
NPI
1336407758
Phone
(970) 350-4606
Address
2930 11TH AVE
Enumeration Date
24 April 2012
Last Update Date
26 July 2016

Doctor Profile

Medical School Name
UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Secondary Phone
9706694855
Graduation Year
2012 (14 years ago)
PAC ID
3173755840
Group Practice PAC ID
0648164780
Professional Enrollment ID
I20150918002471
Address ID
CO805376419LO302XXSEXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:14State licenses:1Digital endpointsOther names

2,661 FAMILY PRACTICE in CO

Provider Addresses for SAMUEL WAYNE DAVIS (MD)

  • 2930 11TH AVE

    EVANS, CO 806201011

    Phone: (970) 350-4606

    Fax: (970) 350-4645

    Type: Mailing

  • 1010 A ST

    GREELEY, CO 806312021

    Phone: (970) 313-0400

    Fax: (970) 313-0404

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-05-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140514001598IFamily PracticeCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
83036Hemoglobin a1c level5343$0
82962Blood glucose (sugar) test performed by hand-held instrument4236$0
View full utilization report →

Insurance plans in this area (ZIP 80620)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648164780View full group profile
NameSpecialtyState
Nurse PractitionerCO
Physician AssistantCO
Family PracticeCO
Nurse PractitionerCO
Physician AssistantCO
Nurse PractitionerCO
Physician AssistantTX
-CO
Nurse PractitionerCO
Physician AssistantCO

Reviews

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Frequently asked questions

What is the 10-digit NPI for SAMUEL WAYNE DAVIS (MD)?
SAMUEL WAYNE DAVIS (MD) — NPI 1336407758 — is the standard way to identify this listing.
Is SAMUEL WAYNE DAVIS (MD) listed as active for patients and plans?
The listing shows SAMUEL WAYNE DAVIS (MD) as active in the NPI system.
What is SAMUEL WAYNE DAVIS (MD)'s primary classification?
Family Medicine Physician is the headline specialty for SAMUEL WAYNE DAVIS (MD) here. Clinical services aligned with this taxonomy classification.
What address line appears for SAMUEL WAYNE DAVIS (MD)?
SAMUEL WAYNE DAVIS (MD)'s geographic hint is Evans, Colorado in our summary view.
Is the information about SAMUEL WAYNE DAVIS (MD) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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