ANTHONY B SR. DAVIS (PA) – Physician Assistant, NPI 1285722991

ANTHONY B SR. DAVIS (PA) is a healthcare provider. based in Moultrie, Georgia. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. 002208 (GA). The NPI Number for ANTHONY B SR. DAVIS (PA) is 1285722991

Main info

Male
36 Years Of Experience
Accepts Medicare Assignment
Name
ANTHONY B SR. DAVIS (PA)
NPI
1285722991
Phone
(229) 785-2400
Address
PO BOX 1539
Enumeration Date
10 October 2006
Last Update Date
8 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2298919131
Graduation Year
1990 (36 years ago)
PAC ID
9931156338
Group Practice PAC ID
0840455192
Professional Enrollment ID
I20050407000684
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for ANTHONY B SR. DAVIS (PA)

  • PO BOX 1539

    MOULTRIE, GA 317761539

    Phone: (229) 785-2400

    Type: Mailing

  • 4, Live Oak Court, Moultrie, Colquitt County, Georgia, 31768, United States

    MOULTRIE, GA 317686783

    Phone: (229) 785-2400

    Type: Location

  • 16 LIVE OAK CT

    MOULTRIE, GA 31768

    Phone: (229) 891-9148

    Type: Location

  • PO BOX 2876

    MOULTRIE, GA 317762876

    Phone: (229) 891-9148

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 70 Open Payments records for all available years, with a total value of $2,126.

Total Amount is formed as General ($2,126) + Research ($0) + Ownership ($0) = $2,126.

Last reported payment date: 2024-12-09 • Largest payer in this snapshot: Axonics, Inc. ($452).

Total Amount

$2,126

General + Research + Ownership

Payments

70

Total payment records

General Amount

$2,126

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-09

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2005-04-07

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
I20050407000684IPhysician AssistantGATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 31776)

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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: 0840455192View full group profile
NameSpecialtyState
U R O L O G YGA
U R O L O G YWI

Reviews

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Frequently asked questions

Does ANTHONY B SR. DAVIS (PA) have a public NPI I can cite?
Public records show ANTHONY B SR. DAVIS (PA) under NPI 1285722991.
Does the public listing show ANTHONY B SR. DAVIS (PA) as active?
ANTHONY B SR. DAVIS (PA)'s NPI record reflects an active status in NPPES.
Which specialty label fits ANTHONY B SR. DAVIS (PA)?
NPPES ties ANTHONY B SR. DAVIS (PA) to Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to ANTHONY B SR. DAVIS (PA)?
The directory associates ANTHONY B SR. DAVIS (PA) with Moultrie, Georgia. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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