Individual provider Active NPI

Ryan Arlene Davis, DPT

  • Physical Therapist
  • Ellsworth, ME
National Provider Identifier
1205315058
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5194 Issued in ME
Practice address
17 Commerce Park
Ellsworth, ME 04605-3383
Phone
(207) 992-4000
Fax
(207) 558-3285
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5194 ME Primary

Addresses

Primary practice location

17 Commerce Park
Ellsworth, ME 04605-3383

Mailing address

PO Box 6
Stillwater, ME 04489-0006
Phone (207) 992-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180918000383 ME Practitioner - Physical Therapist in Private Practice 5496006371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ube Physical Therapy and Performance LLCGroup PAC ID 5698064798, 3 clinicians

Practice addresses (Care Compare)

17 Commerce Park
Ellsworth, ME 04605-3383
Phone (207) 992-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5194MEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ube Physical Therapy and Performance LLC Physical Therapist CurrentSince Feb 18, 2019 Accepting new patients

Locations

1211 Broadway
Ste 8
Bangor, ME 04401
Phone (207) 992-4000

175 Union St
Ste A
Bangor, ME 04401
Phone (207) 949-0552

17 Commerce Park
Ellsworth, ME 04605
Phone (207) 949-0552

14 Mariaville Rd
Ellsworth, ME 04605
Phone (207) 992-4000

8 Road Not Taken
Trenton, ME 04605
Phone (207) 992-4000

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.

NPI Registry JSON

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1205315058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6",
            "city": "STILLWATER",
            "state": "ME",
            "postal_code": "044890006",
            "telephone_number": "207-992-4000",
            "fax_number": "207-558-3285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 COMMERCE PARK",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046053383",
            "telephone_number": "207-992-4000",
            "fax_number": "207-558-3285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RYAN",
        "middle_name": "ARLENE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT5194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellsworth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.