Active NPI
Jessica Lynn Davis, PTA
- Physical Therapy Assistant
- Lanham, MD
National Provider Identifier
1245674969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A3314
- Practice address
- 8200 Good Luck Rd
Lanham, MD 20706-3511 - Phone
- (301) 552-2000
- NPI assigned
- Apr 24, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A3314 | MD | Primary |
Addresses
Primary practice location
8200 Good Luck Rd
Lanham, MD 20706-3511
Mailing address
8420 Park Rd
Pasadena, MD 21122-2957
Phone (443) 618-3339
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 |
|---|---|---|---|
| A3314 | MD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366761600000",
"number": "1245674969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8420 PARK RD",
"city": "PASADENA",
"state": "MD",
"postal_code": "211222957",
"telephone_number": "443-618-3339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8200 GOOD LUCK RD",
"city": "LANHAM",
"state": "MD",
"postal_code": "207063511",
"telephone_number": "301-552-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JESSICA",
"middle_name": "LYNN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-24",
"last_updated": "2013-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A3314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lanham, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.