Micheal Davis

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

2019-3729-01 Issued in NC

Practice address

6047 Tyvola Glen Cir Ste 113
Charlotte, NC 28217-6431

Phone

(803) 431-5044

NPI assigned

Nov 10, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• New Life Peer Support and Coaching LLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1255949731
  NPD Authorized official

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1215539788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6047 TYVOLA GLEN CIR STE 113",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282176431",
            "telephone_number": "803-431-5044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6047 TYVOLA GLEN CIR STE 113",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282176431",
            "telephone_number": "803-431-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MICHEAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-10",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NC",
            "license": "2019-3729-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Davis, DPT
• Melissa A Davis, PT
• Melissa Elizabeth Davis, LCMHC
• Melissa La Russo Davis, CPNP
• Meredith Davis, LAT, ATC
• Michelle Davis, LCSW
• Natalie Davis
• Nattia Davis, MS
• Nicolette Threatt Davis, PA
• Nina Michele Davis, LPC

• All providers in Charlotte, NC
• Peer Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.