Individual provider Active NPI

David J Davis III, D.C.

  • Chiropractor
  • Clearwater, FL
National Provider Identifier
1225436470
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH 11342 Issued in FL
Practice address
1400 Court St
Clearwater, FL 33756-6147
Phone
(727) 446-5250
NPI assigned
Dec 19, 2014
Last updated
Dec 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH 11342 FL Primary

Addresses

Primary practice location

1400 Court St
Clearwater, FL 33756-6147

Mailing address

1400 Court St
Clearwater, FL 33756-6147
Phone (727) 446-5250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160322001362 GA Practitioner - Chiropractic 1759606148 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

120 Jackson St
Suite C
Swainsboro, GA 30401-3160
Phone (478) 268-9011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 11342FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Wellness PC Chiropractor CurrentSince Jul 1, 2019 Accepting new patients

Locations

120 Jackson St
Ste C
Swainsboro, GA 30401
Phone (478) 237-7246

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1418947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418947200000",
    "number": "1225436470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 COURT ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337566147",
            "telephone_number": "727-446-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 COURT ST",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337566147",
            "telephone_number": "727-446-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-19",
        "last_updated": "2014-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 11342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; 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.