Brantley Warren Davis, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

211203 Issued in TX

Practice address

19 N Mill St
Sumrall, MS 39482-4035

Phone

(601) 466-9638

NPI assigned

Oct 18, 2011

Last updated

Oct 18, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1003191461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 N MILL ST",
            "city": "SUMRALL",
            "state": "MS",
            "postal_code": "394824035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 N MILL ST",
            "city": "SUMRALL",
            "state": "MS",
            "postal_code": "394824035",
            "telephone_number": "601-466-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRANTLEY",
        "middle_name": "WARREN",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-18",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "211203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon L Coleman, D. O.
• Community Care Transportation LLC
• Covington County Hospital (Covington Health Sumrall)
• Alice Crosby
• Bailey Rene Davis, DMD
• Erika Rochelle Davis
• Melody Davisson, LCSW
• Grace E Dickerson, LMFT
• Susan L Dubose, FNP-BC
• Family Drug Mart of Sumrall, LLC (Family Drug Mart of Sumrall)

• Occupational Therapy Assistant in Sumrall, MS
• Providers in Sumrall, MS by specialty
• Occupational Therapy Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.