Individual provider Active NPI

Michanne M Davis

  • Clinical Social Worker
  • Cincinnati, OH
National Provider Identifier
1104404680
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1200901-SUPV Issued in OH
Practice address
4700 E Galbraith Rd Ste 202
Cincinnati, OH 45236-2754
Phone
(513) 891-5532
Fax
(513) 924-8369
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.1200901-SUPV OH Primary

Addresses

Primary practice location

4700 E Galbraith Rd Ste 202
Cincinnati, OH 45236-2754

Mailing address

4700 E Galbraith Rd Ste 202
Cincinnati, OH 45236-2754
Phone (513) 891-5532

Other practice location 1

225 Calhoun St Ste 200
Cincinnati, OH 45219-1893
Phone (513) 556-0648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241210004502 OH Practitioner - Clinical Social Worker 7618403940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Cincinnati Specialty Care LLCGroup PAC ID 3971907759, 343 clinicians

Practice addresses (Care Compare)

4700 E Galbraith Rd
Suite 202
Cincinnati, OH 45236-2754
Phone (513) 891-5532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Jan 26, 2025 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Jan 26, 2025 Accepting new patients
University of Cincinnati Counseling & Psychological Services PastSince Apr 1, 2021 Accepting new patients

Locations

4700 E Galbraith Rd
Ste 202
Cincinnati, OH 45236
Phone (513) 418-5700

1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000

201 Old Bank Rd
Ste 103
Milford, OH 45150
Phone (513) 248-0100

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": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1104404680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 E GALBRAITH RD STE 202",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452362754",
            "telephone_number": "513-891-5532",
            "fax_number": "513-924-8369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 E GALBRAITH RD STE 202",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452362754",
            "telephone_number": "513-891-5532",
            "fax_number": "513-924-8369"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Calhoun St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452191893",
            "country_code": "US",
            "telephone_number": "513-556-0648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MICHANNE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1200901-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.