Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Cody C Davis, PA-C

Individual provider Physician Assistant · NPI 1912257536

Cody C Davis, PA-C is a Physician Assistant in Indian Head, Maryland. Qualified in 2012, 14 years ago. Practices with Emergency Physicians of Tidewater, a 165-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
14
Licensed in
AZ
In the registry since
2012
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4141 W Wilson Rd Bldg 1600
Indian Head, MD 20640-5162
Phone: (310) 744-1059
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5198 (AZ)

Record details

NPI number1912257536
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 11, 2012
Last updated in NPPESApril 10, 2024
Certification dateApril 10, 2024
Mailing address4141 W Wilson Rd Bldg 1600, Indian Head, MD 20640-5162

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Emergency Physicians Of Tidewater — 165 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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