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

Thaddeus Davis, OD

Individual provider Optometrist · NPI 1568148039

Thaddeus Davis, OD is an Optometry in Phoenix, Arizona. Qualified in 2023, 3 years ago. Practices with Nationwide Optometry PC, a 55-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona, Idaho and Washington.

Years since qualifying
3
Licensed in
AZ, ID, WA
In the registry since
2023
Specialties on file
3
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

610 E Baseline Rd Ste C3
Phoenix, AZ 85042-6536
Phone: (602) 269-9771
Fax: (602) 268-0899
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 560 Se Bishop Blvd, Pullman, WA 99163-5505 — (509) 334-3300

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence OPT-00779 (AZ)
Optometrist Taxonomy 152W00000X · Licence OD61467516 (WA)
Optometrist Taxonomy 152W00000X · Licence ODP-100630 (ID)

Record details

NPI number1568148039
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorYes
NPI enumeratedJune 27, 2023
Last updated in NPPESMay 24, 2024
Certification dateMay 24, 2024
Mailing address955 W Southern Ave Ste 101, Mesa, AZ 85210-4903

Medicare enrollment

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

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Nationwide Optometry P.C. — 55 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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