Charles Henry Davis

Primary specialty

Orthotic FitterTaxonomy code 225000000X

Practice address

4859 Shed Rd
Suite 200
Bossier City, LA 71111

Phone

(318) 746-5000

Fax

(318) 746-4000

NPI assigned

Sep 24, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193443200000",
    "number": "1174719033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4859 SHED RD",
            "address_2": "SUITE 200",
            "city": "BOSSIER",
            "state": "LA",
            "postal_code": "711114859",
            "telephone_number": "318-746-5000",
            "fax_number": "318-746-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4859 SHED RD",
            "address_2": "SUITE 200",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "71111",
            "telephone_number": "318-746-5000",
            "fax_number": "318-746-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHARLES",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-24",
        "last_updated": "2007-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Raines Community Health Center, Inc
• Jenna Elizabeth Davila, IDMT
• Ayanna Binta Davis
• Brenda Faye Davis
• Casey Glasgow Davis, P.T.
• Gregory Wayne Davis, HIS
• Heidi Davis
• James Davis
• Lugene Davis IV
• Myesha Davis

• Orthotic Fitter in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Orthotic Fitter in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.