Individual provider Active NPI

James Thomas Davis, PSYD

  • Psychologist
  • Crestview Hills, KY
National Provider Identifier
1124028543
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
00838 Issued in KY
Practice address
334 Thomas More Pkwy
Crestview Hills, KY 41017-3464
Phone
(859) 301-5901
Fax
(859) 301-5940
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5094 OH
Clinical Psychologist 103TC0700X 00838 KY
Psychologist 103T00000X 00838 KY Primary

Addresses

Primary practice location

334 Thomas More Pkwy
Crestview Hills, KY 41017-3464

Mailing address

PO Box 635283
St. Elizabeth Physicians
Cincinnati, OH 45263-5283
Phone (859) 301-5901

Other identifiers 1

IdentifierTypeStateIssuer
89000541MedicaidKY

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20080926000523 KY Practitioner - Clinical Psychologist 9638246028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00838KYMDPsychologist
5094OHMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc Psychologist CurrentSince Dec 1, 2012 Accepting new patients
St Elizabeth Medical Center, Inc CurrentSince May 23, 2008 Accepting new patients
St Elizabeth Medical Center, Inc Psychologist CurrentSince May 23, 2008 Accepting new patients
Summit Medical Group, Inc. CurrentSince Dec 1, 2012 Accepting new patients

Locations

334 Thomas More Pkwy
Crestview Hills, KY 41017
Phone (859) 331-6065

20 Medical Village Dr
Ste 204
Edgewood, KY 41017
Phone (859) 301-5959

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

2300 Chamber Center Dr
Lakeside Park, KY 41017
Phone (859) 341-3114

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000

Interoperability endpoints

  • Direct secure messaging: jdavis145229@direct-prd.stelizabeth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1124028543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "address_2": "ST. ELIZABETH PHYSICIANS",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-301-5901",
            "fax_number": "859-301-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 THOMAS MORE PKWY",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173464",
            "telephone_number": "859-301-5901",
            "fax_number": "859-301-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAMES",
        "middle_name": "THOMAS",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "5094",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "00838",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "00838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89000541",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

Verify at the official NPI Registry.