Shaka-Con Davis

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

License

1111111111111 Issued in NC

Practice address

1909 J N Pease PL Ste 104
Charlotte, NC 28262-4561

Phone

(980) 224-8078

NPI assigned

Jul 3, 2023

Last updated

Jul 3, 2023By the provider in NPPES

Sex

Female

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

Practice roles

Locations

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

• Verifi Charlotte LLC

  • Health Service Clinic/Center
  • Charlotte, NC
  • NPI 1942060223
  NPD Authorized official

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1043997968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 J N PEASE PL STE 104",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624561",
            "telephone_number": "980-224-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 J N PEASE PL STE 104",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624561",
            "telephone_number": "980-224-8078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHAKA-CON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-03",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prevention Professional",
            "state": "NC",
            "license": "1111111111111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Dionne Davis
• Sarah Rose Davis, MD
• Savannah Marie Davis, NP
• Serenity Lanette Davis
• Sha'Rita Jenna Davis, LCMHCA
• Shaniqua Davis
• Shannon Davis
• Shannon Newton Davis, FNP
• Sharneice Davis, FNP-BC
• Spencer Harrison Davis, PHARM D

• Prevention Professional in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Prevention Professional in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.