Davis Health & Wellness Clinic, P.C.
Organization Active NPI Primary Care Clinic/Center · Dexter, MO
NPI 1154066561 · NPPES record last updated Apr 29, 2022
Key facts
- NPI
- 1154066561
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- DAVIS HEALTH & WELLNESS CLINIC, P.C.
- Practice address
- 808 Speciality Dr Ste a
Dexter, MO 63841-2753 - Phone
- (573) 891-1250
- Fax
- (573) 891-1320
- NPI assigned
- Apr 29, 2022
- Organization subpart
- No
Authorized official
- Name
- Bradford Joseph Davis, FNP-BC
- Title
- Owner/Provider
- Phone
- (573) 891-1250
Practitioners 1
-
Bradford Joseph Davis, FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230204000423 | MO | Part B Supplier - Clinic/Group Practice | 6608248448 |
Receives reassigned benefits from 1 practitioner Practice locations: Dexter, MO |
National Provider Directory
Locations
808 Speciality Dr
#A
Dexter, MO 63841
Phone (573) 891-1250
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
808 Speciality Dr Ste a
Dexter, MO 63841-2753
Mailing address
PO Box 603
Dexter, MO 63841-0603
Phone (573) 891-1250
Other providers in Dexter, MO
- Krista Lynn Conde
- Brendan Robert Crader
- Martha Crawford
- D&S Drug LLC
- D&S Drug LLC
- Bradford Joseph Davis
- Savannah Joy Deane
- Demaree Mitchell Family Dentistry LLC
- Derek Demaree
- Terry W Demaree
All providers in Dexter, MO · Primary Care Clinic/Center in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.