Active NPI
Robert Ellsworth Davis II, PT
- Physical Therapist
- Mount Hope, WV
National Provider Identifier
1255529822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 001310
- Practice address
- 115 Albany LN
Mount Hope, WV 25880-9648 - Phone
- (304) 253-3780
- NPI assigned
- Oct 9, 2007
- Sex
- Male
- 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 Therapist | 225100000X | 001310 | WV | Primary |
Addresses
Primary practice location
115 Albany LN
Mount Hope, WV 25880-9648
Mailing address
115 Albany LN
Mount Hope, WV 25880-9648
Phone (304) 253-3780
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 |
|---|---|---|---|
| 001310 | WV | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marden Rehabilitation Associates of Portage County, Inc. | Physical Therapist | Past | Accepting new patients |
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.
-
- Physical Therapist
- Oceana, WV
- NPI 1902913866
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191888000000",
"number": "1255529822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 ALBANY LN",
"city": "MOUNT HOPE",
"state": "WV",
"postal_code": "258809648",
"telephone_number": "304-253-3780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 ALBANY LN",
"city": "MOUNT HOPE",
"state": "WV",
"postal_code": "258809648",
"telephone_number": "304-253-3780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ROBERT",
"middle_name": "ELLSWORTH",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-09",
"last_updated": "2007-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "001310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Hope, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.