Active NPI
Kerry Deanna Davis
- Social Worker
- Orangeburg, NY
National Provider Identifier
1003135849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 069777-1
- Practice address
- 140 Old Orangeburg Rd, Building #1
Orangeburg Bilingual Clinic-English/Asl, Rockland Psych
Orangeburg, NY 10962 - Phone
- (845) 359-1000
- NPI assigned
- May 19, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 069777-1 | NY | Primary |
Addresses
Primary practice location
140 Old Orangeburg Rd, Building #1
Orangeburg Bilingual Clinic-English/Asl, Rockland Psych
Orangeburg, NY 10962
Mailing address
140 Old Orangeburg Rd
Building #1, Orangeburg Bilingual Clinic-English/Asl
Orangeburg, NY 10962
Phone (845) 398-7076
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180525000801 | NY | Order and Referring Only - Clinical Social Worker | 2365707114 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 069777-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274227200000",
"number": "1003135849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 OLD ORANGEBURG RD",
"address_2": "BUILDING #1, ORANGEBURG BILINGUAL CLINIC-ENGLISH/ASL",
"city": "ORANGEBURG",
"state": "NY",
"postal_code": "10962",
"telephone_number": "845-398-7076",
"fax_number": "845-398-7056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 OLD ORANGEBURG RD, BUILDING #1",
"address_2": "ORANGEBURG BILINGUAL CLINIC-ENGLISH/ASL, ROCKLAND PSYCH",
"city": "ORANGEBURG",
"state": "NY",
"postal_code": "10962",
"telephone_number": "845-359-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KERRY",
"middle_name": "DEANNA",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-19",
"last_updated": "2010-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "069777-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orangeburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.