Active NPI
Archie Davis III
- Social Worker
- Washington, DC
National Provider Identifier
1164800439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LG50078801
- Practice address
- 712 H St NE
Washington, DC 20002-3627 - Phone
- (240) 559-4010
- NPI assigned
- May 7, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 13982 | MD | |
| Social Worker | 104100000X | LG50078801 | DC | Primary |
Addresses
Primary practice location
712 H St NE
Washington, DC 20002-3627
Mailing address
712 H St NE
Washington, DC 20002-3627
Phone (240) 559-4010
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LG50078801 | DC | MD | Social Worker |
| 13982 | MD | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Imind Health LLC | 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.
-
- Substance Abuse Rehabilitation Facility
- Lanham, MD
- NPI 1497218317
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780358400000",
"number": "1164800439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "712 H ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200023627",
"telephone_number": "240-559-4010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 H ST NE",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200023627",
"telephone_number": "240-559-4010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ARCHIE",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-07",
"last_updated": "2026-06-02",
"certification_date": "2026-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "13982",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "DC",
"license": "LG50078801",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.