Active NPI
Miles Ernest Davison, LCSW
- Clinical Social Worker
- Roanoke, VA
National Provider Identifier
1154838290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 0904010320
- Practice address
- 1719 Grandin Rd SW
Roanoke, VA 24015-2815 - Phone
- (215) 840-5034
- NPI assigned
- Jan 10, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904010320 | VA | Primary |
Addresses
Primary practice location
1719 Grandin Rd SW
Roanoke, VA 24015-2815
Mailing address
2049 Windsor Ave SW Apt 4
Roanoke, VA 24015-2331
Phone (215) 840-5034
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Colonial Behavioral Health | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Health Maintenance Organization
- Williamsburg, VA
- NPI 1841556776
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515542400000",
"number": "1154838290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2049 WINDSOR AVE SW APT 4",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240152331",
"telephone_number": "215-840-5034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1719 GRANDIN RD SW",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240152815",
"telephone_number": "215-840-5034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVISON",
"first_name": "MILES",
"middle_name": "ERNEST",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-10",
"last_updated": "2018-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904010320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.