Active NPI
Jordan Elizabeth Davis
- Occupational Therapist
- Gasport, NY
National Provider Identifier
1043728223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 022182
- Practice address
- 4500 Orchard PL
Gasport, NY 14067-9208 - Phone
- (716) 735-2000
- NPI assigned
- Jan 22, 2018
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 022182 | NY | Primary |
Addresses
Primary practice location
4500 Orchard PL
Gasport, NY 14067-9208
Mailing address
125 Woodstream Dr
Grand Island, NY 14072-1490
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022182 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516579200000",
"number": "1043728223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 WOODSTREAM DR",
"city": "GRAND ISLAND",
"state": "NY",
"postal_code": "140721490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 ORCHARD PL",
"city": "GASPORT",
"state": "NY",
"postal_code": "140679208",
"telephone_number": "716-735-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JORDAN",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-22",
"last_updated": "2018-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "022182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gasport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.