Active NPI
Teresa L Davis, PCC-S
- Professional Counselor
- Ontario, OH
National Provider Identifier
1114229002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E0003209
- Practice address
- 1805 Park Ave W
Ontario, OH 44906-2229 - Phone
- (419) 529-4420
- Fax
- (419) 529-4677
- NPI assigned
- Nov 26, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E0003209 | OH | Primary |
Addresses
Primary practice location
1805 Park Ave W
Ontario, OH 44906-2229
Mailing address
1805 Park Ave W
Ontario, OH 44906-2229
Phone (419) 529-4420
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E0003209 | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| T. R. Davis D.C. Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic/Center
- Ontario, OH
- NPI 1073890034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290729600000",
"number": "1114229002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1805 PARK AVE W",
"city": "ONTARIO",
"state": "OH",
"postal_code": "449062229",
"telephone_number": "419-529-4420",
"fax_number": "419-529-4677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1805 PARK AVE W",
"city": "ONTARIO",
"state": "OH",
"postal_code": "449062229",
"telephone_number": "419-529-4420",
"fax_number": "419-529-4677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "TERESA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "PCC-S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-26",
"last_updated": "2010-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E0003209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ontario, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2010; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.