Individual provider Active NPI

Rebecca A Davis, AUDIOLOGIST

  • Audiologist-Hearing Aid Fitter
  • Tyler, TX
National Provider Identifier
1144411646
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
50630 Issued in TX
Practice address
2501 E 5TH St
Tyler, TX 75701-3544
Phone
(903) 593-7977
Fax
(903) 593-7899
NPI assigned
Aug 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 50630 TX Primary

Addresses

Primary practice location

2501 E 5TH St
Tyler, TX 75701-3544

Mailing address

2501 E 5TH St
Tyler, TX 75701-3544
Phone (903) 593-7977

Other identifiers 3

IdentifierTypeStateIssuer
0085MEOtherTXBCBS
80374AOtherTXBCBS
80259AOtherTXBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090618000621 TX Practitioner - Qualified Audiologist 1557304961 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eric L. Hensen, DO PA CurrentSince Oct 16, 2018 Accepting new patients
Ahs Audiology & Hearing Care, LLC Audiologist-Hearing Aid Fitter CurrentSince Jun 4, 2009 Accepting new patients

Locations

112 Medical Dr
Palestine, TX 75801
Phone (214) 729-0444

2501 E 5th St
Tyler, TX 75701
Phone (903) 593-7977

Organizations & group practices 2

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": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1144411646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013544",
            "telephone_number": "903-593-7977",
            "fax_number": "903-593-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013544",
            "telephone_number": "903-593-7977",
            "fax_number": "903-593-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "REBECCA",
        "middle_name": "A",
        "credential": "AUDIOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": "50630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0085ME",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "80374A",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "80259A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.