Individual provider Active NPI

Roger A Davis II, PT, DPT

  • Physical Therapist
  • Louisville, KY
National Provider Identifier
1114941101
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2420 Lime Kiln LN Ste C
Louisville, KY 40222-3425
Phone
(502) 630-3296
Fax
(502) 630-3302
NPI assigned
Jul 26, 2006
Last updated
Feb 14, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

2420 Lime Kiln LN Ste C
Louisville, KY 40222-3425

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-4915
Phone (423) 238-8930

Other practice location 1

13050 Magisterial Dr
Suite 100
Louisville, KY 40223-5180
Phone (502) 245-1061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140717002166 KY Practitioner - Physical Therapist in Private Practice 9335365816 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Kentucky LLC Physical Therapist CurrentSince May 30, 2024 Accepting new patients
Benchmark Physical Therapy of Ky LLC Physical Therapist CurrentSince Sep 2, 2019 Accepting new patients
Drayer Physical Therapy Kentucky LLC Physical Therapist CurrentSince May 30, 2024 Accepting new patients
The P.T. Place, Inc Physical Therapist Past Accepting new patients
Agilitas USA Inc Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1010 Monarch St
Ste 150
Lexington, KY 40513
Phone (859) 219-0211

1588 Leestown Rd
Ste 120
Lexington, KY 40511
Phone (859) 317-8086

12418 La Grange Rd
Ste 115
Louisville, KY 40245
Phone (502) 890-6001

2420 Lime Kiln Ln
Ste C
Louisville, KY 40222
Phone (502) 630-3296

3129 S 2nd St
Louisville, KY 40208
Phone (502) 690-2458

5524 New Cut Rd
#B
Louisville, KY 40214
Phone (502) 290-4783

200 Codella Dr
Ste B
Winchester, KY 40391
Phone (859) 745-2152

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (866) 518-0283

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1114941101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214915",
            "telephone_number": "423-238-8930",
            "fax_number": "423-254-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 LIME KILN LN STE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402223425",
            "telephone_number": "502-630-3296",
            "fax_number": "502-630-3302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13050 Magisterial Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402235180",
            "country_code": "US",
            "telephone_number": "502-245-1061",
            "fax_number": "502-245-1065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROGER",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.