NPIMap

Organization Active NPI

Davis Therapeutic Services LLC

  • Community/Behavioral Health Agency
  • Flowood, MS
National Provider Identifier
1073072013
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DAVIS THERAPEUTIC SERVICES LLC
Practice address
517 Keywood Cir Ste 2B
Flowood, MS 39232-3054
Phone
(601) 559-1880
Fax
(601) 559-1852
NPI assigned
Mar 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Authorized official

Name
Shameika Davis, LCSWNPI 1801308382
Title
Co-Owner
Phone
(601) 502-6639

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

517 Keywood Cir Ste 2B
Flowood, MS 39232-3054

Mailing address

517 Keywood Cir Ste 2B
Flowood, MS 39232-3054
Phone (601) 559-1880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190808000472 MS Part B Supplier - Clinic/Group Practice 5193052512 Receives reassigned benefits from 2 practitioners
Practice locations: Flowood, MS

National Provider Directory

National Provider Directory

Locations

517 Keywood Cir
Ste 2B
Flowood, MS 39232
Phone (601) 559-1880

2135 Henry Hill Dr
Ste 220
Jackson, MS 39204
Phone (601) 559-1880

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1073072013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 KEYWOOD CIR STE 2B",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392323054",
            "telephone_number": "601-559-1880",
            "fax_number": "601-559-1852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 KEYWOOD CIR STE 2B",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392323054",
            "telephone_number": "601-559-1880",
            "fax_number": "601-559-1852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS THERAPEUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-19",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SHAMEIKA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "601-502-6639",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.