Individual provider Active NPI

O Troy Davis, D.C.

  • Chiropractor
  • St George, UT
National Provider Identifier
1053453191
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8328842-1202 Issued in UT
Practice address
1397 W Sunset Blvd Ste 109
St George, UT 84770-4212
Phone
(435) 862-0125
Fax
(435) 215-7680
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4683 KY
Chiropractor 111N00000X 8328842-1202 UT Primary

Addresses

Primary practice location

1397 W Sunset Blvd Ste 109
St George, UT 84770-4212

Mailing address

1397 W Sunset Blvd Ste 109
Saint George, UT 84770-4212
Phone (435) 862-0125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130731000690 UT Practitioner - Chiropractic 5597677021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

321 N Mall Dr
Unit H102
St George, UT 84790-7341
Phone (435) 862-0125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8328842-1202UTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Chiropractic LLC Chiropractor CurrentSince Jul 1, 2017 Accepting new patients
Orbie Troy Davis Chiropractor PastSince Dec 27, 2004 Accepting new patients
Occupational Kinetics Chiropractor Past Accepting new patients

Locations

321 N Mall Dr
Unit H102
St George, UT 84790
Phone (435) 862-0125

1397 W Sunset Blvd
Ste 109
St George, UT 84770
Phone (435) 275-8888

Organizations & group practices 3

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1053453191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1397 W SUNSET BLVD STE 109",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847704212",
            "telephone_number": "435-862-0125",
            "fax_number": "435-215-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1397 W SUNSET BLVD STE 109",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847704212",
            "telephone_number": "435-862-0125",
            "fax_number": "435-215-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "O",
        "middle_name": "TROY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4683",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "8328842-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.