Active NPI
Donnie Britten Davis Jr., ATC
- Athletic Trainer
- Malvern, AR
National Provider Identifier
1093745689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT 364
- Practice address
- 52 Gloster CT
Malvern, AR 72104-3900 - Phone
- (501) 420-4491
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT 364 | AR | Primary |
Addresses
Primary practice location
52 Gloster CT
Malvern, AR 72104-3900
Mailing address
52 Gloster CT
Malvern, AR 72104-3900
Phone (501) 420-4491
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AT 364 | Other | AR | ATHLETIC TRAINER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT 364 | AR | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339804800000",
"number": "1093745689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "52 GLOSTER CT",
"city": "MALVERN",
"state": "AR",
"postal_code": "721043900",
"telephone_number": "501-420-4491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 GLOSTER CT",
"city": "MALVERN",
"state": "AR",
"postal_code": "721043900",
"telephone_number": "501-420-4491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DONNIE",
"middle_name": "BRITTEN",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2012-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AR",
"license": "AT 364",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ATHLETIC TRAINER",
"identifier": "AT 364",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Malvern, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.