Davis Jackson Medical Assist Tean Lee

Primary specialty

Adult CompanionTaxonomy code 372600000X

Legal business name

DAVIS JACKSON MEDICAL ASSIST TEAN LEE

Practice address

6449 Ipth Dr.
Saint Paul, MN 55725-1130

Phone

(657) 592-5960

Fax

(651) 286-2994

NPI assigned

Nov 6, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Florense Monique Davis, CNA

Title

President/Owner

Phone

(651) 595-5960

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1114528973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 E. 78TH STREET APT. 114",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251114",
            "telephone_number": "651-592-5960",
            "fax_number": "651-286-2994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6449 IPTH DR.",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "557251130",
            "telephone_number": "657-592-5960",
            "fax_number": "651-286-2994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS JACKSON MEDICAL ASSIST TEAN LEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "FLORENSE",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "651-595-5960",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CNA"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Henry Gillespie David, PT, DPT
• Sandra Ann Davidson
• Sonchie Davies-Ogunleye
• Hannah Davies, OTR/L
• Jeffrey Scott Davies
• Davis Shryer Dba Acceptance Matters
• Carmel Nicole Davis
• Charles Davis
• Chase Alexander Davis, PA-C
• Heidi Anne Davis, C.N.P.

• Adult Companion in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Adult Companion in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.