Individual provider Active NPI

Ross Taylor Davids, PSYD

  • Clinical Neuropsychologist
  • Sun City, AZ
National Provider Identifier
1053008482
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
0055664 Issued in AZ
Practice address
13640 N 99TH Ave Ste 100
Sun City, AZ 85351-0001
Phone
(623) 322-5700
NPI assigned
Apr 18, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 0055664 AZ Primary

Addresses

Primary practice location

13640 N 99TH Ave Ste 100
Sun City, AZ 85351-0001

Mailing address

13640 N 99TH Ave Ste 100
Sun City, AZ 85351-0001

Other practice location 1

14418 W Meeker Blvd Ste 200
Sun City West, AZ 85375-5291
Phone (623) 322-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20230727001250 AZ Practitioner - Clinical Psychologist 8729449491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Az Integrated Neuro Spine and Pain LLCGroup PAC ID 5597027516, 15 clinicians

Practice addresses (Care Compare)

13640 N 99TH Ave
Suite 100
Sun City, AZ 85351-0001
Phone (623) 322-5700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0055664AZMDClinical Neuropsychologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1053008482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13640 N 99TH AVE STE 100",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853510001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 N 99TH AVE STE 100",
            "city": "SUN CITY",
            "state": "AZ",
            "postal_code": "853510001",
            "telephone_number": "623-322-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14418 W Meeker Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Sun City West",
            "state": "AZ",
            "postal_code": "853755291",
            "country_code": "US",
            "telephone_number": "623-322-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDS",
        "first_name": "ROSS",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-18",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "0055664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, AZ

Sources for this page

Verify at the official NPI Registry.