Individual provider Active NPI

Michael Kenny Davis, DC

  • Chiropractor
  • Harlingen, TX
National Provider Identifier
1124387212
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4786 Issued in TX
Practice address
712 N Snshn Strip Ste 35
Harlingen, TX 78550-8897
Phone
(956) 203-9854
NPI assigned
May 9, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X 4786 TX
Chiropractor 111N00000X 4786 TX Primary

Addresses

Primary practice location

712 N Snshn Strip Ste 35
Harlingen, TX 78550-8897

Mailing address

712 N Snshn Strip Ste 35
Harlingen, TX 78550-8897
Phone (956) 203-9854

Other identifiers 2

IdentifierTypeStateIssuer
TXB153795OtherTXINDIVIDUAL PTAN
1124387212OtherTXNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120626000280 TX Practitioner - Chiropractic 1951566900 Practice locations: Harlingen, TX

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

712 N 77 Sunshine Strip
Suite 35
Harlingen, TX 78550-8897
Phone (956) 203-9854

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
13997CAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1124387212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 N SNSHN STRIP STE 35",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508897",
            "telephone_number": "956-203-9854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 N SNSHN STRIP STE 35",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508897",
            "telephone_number": "956-203-9854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MICHAEL",
        "middle_name": "KENNY",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-09",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "4786",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "4786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "TXB153795",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1124387212",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.