MEDICARE: DR. JARED DAVIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084A2900X	Neurocritical Care Physician	036-142866	IL
2	2084N0400X	Neurology Physician	MD70054286	WA
3	2084A2900X	Neurocritical Care Physician	04-51975	KS
4	2084N0400X	Neurology Physician	MD227513	OR
5	2084A2900X	Neurocritical Care Physician	NCC5557	IL

General Provider Information

NPI Number	:	1487095659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JARED DAVIS M.D.

Provider Business Mailing Address
First Line	:	3377 RIVERBEND DR
Second Line	:
City	:	SPRINGFIELD
State	:	OR
Zip	:	97477-8803
Country	:	US
Telephone Number	:	541-222-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	5841 S MARYLAND AVE # MC2030
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-1447
Country	:	US
Telephone Number	:	773-702-6390
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2013
Last Update Date	:	12/04/2025

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