Active NPI
Debra V Davis
- Clinical Social Worker
- Medford, OR
National Provider Identifier
1013787704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW22221
- Practice address
- 710 Cardley Ave Ste 2
Medford, OR 97504-6289 - Phone
- (561) 596-4455
- NPI assigned
- Jan 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW22221 | FL | Primary |
Addresses
Primary practice location
710 Cardley Ave Ste 2
Medford, OR 97504-6289
Mailing address
445 S 5TH St
Jacksonville, OR 97530-9775
Phone (561) 596-4455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2026 through Apr 1, 2028
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Florida Atlantic University, College of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
891 Ohare Pkwy
Medford, OR 97504-4005
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW22221 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786665600000",
"number": "1013787704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 S 5TH ST",
"city": "JACKSONVILLE",
"state": "OR",
"postal_code": "975309775",
"telephone_number": "561-596-4455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 CARDLEY AVE STE 2",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975046289",
"telephone_number": "561-596-4455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DEBRA",
"middle_name": "V",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-04",
"last_updated": "2026-08-14",
"certification_date": "2026-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW22221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.