Active NPI
Robert T. Davis, MS, L.AC.
- Acupuncturist
- South Burlington, VT
National Provider Identifier
1063546901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 091-0000072
- Practice address
- 39 Timber Lane
South Burlington, VT 05403 - Phone
- (802) 862-8880
- Fax
- (802) 862-8887
- NPI assigned
- Mar 15, 2007
- Last updated
- Apr 20, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 091-0000072 | VT | Primary |
Addresses
Primary practice location
39 Timber Lane
South Burlington, VT 05403
Mailing address
39 Timber Lane
South Burlington, VT 05403
Phone (802) 862-8880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 030362348 | Other | VT | FEDERAL TAX ID |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 091-0000072 | VT | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681948800000",
"number": "1063546901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 TIMBER LANE",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "05403",
"telephone_number": "802-862-8880",
"fax_number": "802-862-8887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 TIMBER LANE",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "05403",
"telephone_number": "802-862-8880",
"fax_number": "802-862-8887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ROBERT",
"middle_name": "T.",
"name_prefix": "Mr.",
"credential": "MS, L.AC.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-15",
"last_updated": "2023-04-20",
"certification_date": "2023-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "VT",
"license": "091-0000072",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID",
"identifier": "030362348",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.