Individual provider Active NPI

Timothy O Davis, LSCSW

  • Clinical Social Worker
  • Hays, KS
National Provider Identifier
1013087196
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2223 Issued in KS
Practice address
2214 Canterbury Dr
Ste 300
Hays, KS 67601-2386
Phone
(785) 623-5160
NPI assigned
Nov 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2223 KS Primary

Addresses

Primary practice location

2214 Canterbury Dr
Ste 300
Hays, KS 67601-2386

Mailing address

2214 Canterbury Dr
Ste 300
Hays, KS 67601-2397

Other identifiers 2

IdentifierTypeStateIssuer
100425770AMedicaidKS
069645OtherKSMEDICARE ID

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Kansas School of Med (KC/Wich/Sal), 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hays Medical Center Inc 188 clinicians

Practice addresses (Care Compare)

2214 Canterbury Dr
Suite 300
Hays, KS 67601-2397
Phone (785) 623-5160

Hospital & facility affiliations

  • Hays Medical Center Hospital, Hays, KS, CCN 170013

Merit-based Incentive Payment System (MIPS)

Final score
85.72 of 100Reported as apm
Quality
68.82
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071110000169 KS Practitioner - Clinical Social Worker 4486742327 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2223KSMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Hays Medical Center, Inc CurrentSince Jul 24, 2002 Accepting new patients
Hays Medical Center, Inc. Current Accepting new patients
Hays Medical Center Inc CurrentSince Jul 24, 2002 Accepting new patients
Hays Medical Center, Inc. Past Accepting new patients

Locations

2214 Canterbury Dr
Ste 300
Hays, KS 67601
Phone (785) 261-7450

2220 Canterbury Dr
Hays, KS 67601
Phone (785) 623-5000

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1013087196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2214 CANTERBURY DR",
            "address_2": "STE 300",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676012397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 CANTERBURY DR",
            "address_2": "STE 300",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676012386",
            "telephone_number": "785-623-5160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TIMOTHY",
        "middle_name": "O",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "2223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100425770A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "069645",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hays, KS

Sources for this page

Verify at the official NPI Registry.