Timothy Wayne Davis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

4142 Issued in TN

Practice address

283 W Broadway Blvd
Jefferson City, TN 37760-2302

Phone

(865) 475-8037

NPI assigned

Jan 25, 2006

Last updated

May 19, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  TN

  Medicare reassignment
• Paradigm Health Services, Inc

  • Mental Health Counselor
  • Clearwater, FL
  • NPI 1578519146

  Clinical

  NPD (past)

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242691200000",
    "number": "1104896745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 WARD ROAD",
            "address_2": "SUITE 106",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800021829",
            "telephone_number": "877-838-4783",
            "fax_number": "888-341-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 W BROADWAY BLVD",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602302",
            "telephone_number": "865-475-8037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TIMOTHY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2009-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "4142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eden A Daniel
• Shawn Daniel
• Morgan Ella Daniels
• Darby House, LLC
• Bruce Davenport
• Amber Nicole Day, PT, DPT
• Jeremy Len Diamond, O.D.
• James David Dolbow
• Dr. William B Harris Gynecology, PC
• Candice Durman, M.ED.-MFT, LMFT

• Clinical Social Worker in Jefferson City, TN
• Providers in Jefferson City, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.