Samantha Lee Davis, M.ED, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-18-31009

Practice address

22461 I-30 Frontage Rd
1100B
Bryant, AR 72022

Phone

(501) 574-3053

NPI assigned

Oct 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Samantha Lee Hartless Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

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.

• Autism in Motion Clinics, LLC

  • Behavior Analyst
  • Bryant, AR
  • NPI 1255850525
  NPD (past)
• Kids Unlimited Learning Academy of Cabot

  • Developmental Disabilities Clinic/Center
  • Cabot, AR
  • NPI 1336731868
  NPD (past)

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1114437548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22641 FRONTAGE RD",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "720229117",
            "telephone_number": "501-547-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22461 I-30 FRONTAGE RD",
            "address_2": "1100B",
            "city": "BRYANT",
            "state": "AR",
            "postal_code": "72022",
            "telephone_number": "501-574-3053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1002 S Vienna St",
            "address_purpose": "LOCATION",
            "city": "Ruston",
            "state": "LA",
            "postal_code": "712705832",
            "country_code": "US",
            "telephone_number": "318-655-0479",
            "fax_number": "318-655-0479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SAMANTHA",
        "middle_name": "LEE",
        "credential": "M.ED, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-12",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "LA",
            "license": "C-022",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-18-31009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "HARTLESS",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allan Michael Dabbs, D.C
• Jennifer Leigh Dabbs, APRN
• David L. Ouellette D.D.S.
• Amanda Davis
• Evan Christopher Davis, DDS
• Dawn Lindsey DNP, Aprn PLLC
• Sarah Dean, OTD, OTR/L
• Bradley Alexander Deckelman, D.D.S.
• Estrella Delacruz
• Justina Louise Delong

• Behavior Analyst in Bryant, AR
• Providers in Bryant, AR by specialty
• Behavior Analyst in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.