Active NPI
Christina Davis
- Clinical Social Worker
- Avon, IN
National Provider Identifier
1053069120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 109794
- Practice address
- 7315 Autumn CT
Avon, IN 46123-7403 - Phone
- (317) 627-2483
- NPI assigned
- Mar 16, 2022
- 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 | 109794 | TX | Primary |
Addresses
Primary practice location
7315 Autumn CT
Avon, IN 46123-7403
Mailing address
4122 Sunrise Cove Dr
San Antonio, TX 78244-3311
Phone (317) 627-2483
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | christina.davis@reignenterprise.biz |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109794 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1053069120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4122 SUNRISE COVE DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782443311",
"telephone_number": "317-627-2483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7315 AUTUMN CT",
"city": "AVON",
"state": "IN",
"postal_code": "461237403",
"telephone_number": "317-627-2483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "CHRISTINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-16",
"last_updated": "2023-10-18",
"certification_date": "2023-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "109794",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "christina.davis@reignenterprise.biz",
"affiliation": "N",
"address_1": "7315 Autumn Ct",
"city": "Avon",
"state": "IN",
"country_code": "US",
"postal_code": "461237403",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Avon, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.