MR. BARTLETT EMORY DAVIS (PAC ATC) – Physician Assistant, NPI 1205058948
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for MR. BARTLETT EMORY DAVIS (PAC ATC)
Vidalia, Toombs County, Georgia, United States
VIDALIA, GA 304751793
Phone: (912) 538-9033
Type: Mailing
10 Doctors St
Metter, GA 304393337
Phone: (912) 685-5741
Type: Location
12 Doctors St
Metter, GA 30439
Phone: (912) 685-5741
Type: Location
Meadows Lane, Vidalia, Toombs County, Georgia, 30474, United States
SUITE H
VIDALIA, GA 304747200
Phone: (912) 538-0040
Fax: (912) 538-8133
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 13 Open Payments records for all available years, with a total value of $227.
Total Amount is formed as General ($227) + Research ($0) + Ownership ($0) = $227.
Last reported payment date: 2024-07-11 • Largest payer in this snapshot: Lilly USA, LLC ($53).
Total Amount
$227
General + Research + Ownership
Payments
13
Total payment records
General Amount
$227
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-11
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2025-12-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070822000813 | I | Physician Assistant | GA | TBD |
| I20230915003226 | I | Physician Assistant | AK | TBD |
| I20231208001837 | I | Physician Assistant | TX | TBD |
| I20251209001991 | I | Physician Assistant | MT | TBD |
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.
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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30475)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | MT | |
| Physician Assistant | MT | |
| H E M A T O L O G Y/ O N C O L O G Y | MT | |
| Nurse Practitioner | MT | |
| Family Practice | OR | |
| Physician Assistant | MT | |
| Physician Assistant | MT | |
| Internal Medicine, Nephrology | MT | |
| Physician Assistant | MT | |
| Family Practice | GA |
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