Active NPI
Jenny Davis, AUD
- Audiologist
- Fort Bliss, TX
National Provider Identifier
1194926345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 679523-4101
- Practice address
- 11335 SSG Sims Street
Fort Bliss, TX 79918 - Phone
- (915) 742-1363
- NPI assigned
- May 29, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | |||
| Audiologist | 231H00000X | 679523-4101 | UT | Primary |
Addresses
Primary practice location
11335 SSG Sims Street
Fort Bliss, TX 79918
Mailing address
11335 SSG Sims Street
Fort Bliss, TX 79938
Phone (915) 742-1363
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 679523-4101 | UT | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710892800000",
"number": "1194926345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11335 SSG SIMS STREET",
"city": "FORT BLISS",
"state": "TX",
"postal_code": "79938",
"telephone_number": "915-742-1363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11335 SSG SIMS STREET",
"city": "FORT BLISS",
"state": "TX",
"postal_code": "79918",
"telephone_number": "915-742-1363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JENNY",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-29",
"last_updated": "2024-03-20",
"certification_date": "2024-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "UT",
"license": "679523-4101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Bliss, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.