Individual provider Active NPI

Jeffrey Scott Davies

  • Marriage & Family Therapist
  • Saint Paul, MN
National Provider Identifier
1124178108
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1608 Issued in MN
Practice address
1378 Lafond Ave
Saint Paul, MN 55104-2436
Phone
(612) 817-3616
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1608 MN Primary

Addresses

Primary practice location

1378 Lafond Ave
Saint Paul, MN 55104-2436

Mailing address

1378 Lafond Ave
Saint Paul, MN 55104-2436
Phone (612) 817-3616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20231221000331 MN Practitioner - Marriage and Family Therapist 3375950975 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1608MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Express Care CurrentSince Jan 1, 2024 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2024 Accepting new patients

Locations

600 W 98th St
Minneapolis, MN 55420
Phone (952) 881-2651

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

3400 W 66th St
Ste 290
Minneapolis, MN 55435
Phone (952) 836-3637

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

Organizations & group practices 3

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1124178108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1378 LAFOND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042436",
            "telephone_number": "612-817-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1378 LAFOND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551042436",
            "telephone_number": "612-817-3616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "JEFFREY",
        "middle_name": "SCOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.