Gabrielle Grace Davis, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA3999 Issued in MS

Practice address

1130 Stateline Rd E Ste D
Southaven, MS 38671-8701

Phone

(662) 536-6884

Fax

(662) 510-5892

NPI assigned

May 4, 2024

Sex

Female

Sole proprietor

No

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.

• Abc Pediatric Therapy of Mississippi, LLC

  • Physical Therapy Clinic/Center
  • Southaven, MS
  • NPI 1821778713
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 4, 2024.

{
    "created_epoch": "1714780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714780800000",
    "number": "1225885437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 STATELINE RD E STE D",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386718701",
            "telephone_number": "662-536-6884",
            "fax_number": "662-510-5892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 STATELINE RD E STE D",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386718701",
            "telephone_number": "662-536-6884",
            "fax_number": "662-510-5892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GABRIELLE",
        "middle_name": "GRACE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-04",
        "last_updated": "2024-05-04",
        "certification_date": "2024-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MS",
            "license": "OTA3999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dash Medical Supplies, LLC
• Sadie Ann Daugereaux, DO
• Sheron Davenport, LPC
• Nathan Carl Davidson, MD
• Colton Grant Davis, DPT
• Kelli H. Davis, LPC
• Kimberly Davis, LPC
• Laura Elizabeth Davis, FNP
• Michelle Davis
• Pamela Lynn Davis, PAC

• All providers in Southaven, MS
• Occupational Therapy Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.

Verify at the official NPI Registry.