Individual provider Active NPI

Nancy Phillips Davis, LPTA

  • Physical Therapy Assistant
  • Ridgeland, MS
National Provider Identifier
1265700579
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA4431 Issued in MS
Practice address
524 Lakeview CV
Ridgeland, MS 39157-1117
Phone
(601) 259-4710
NPI assigned
Dec 1, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA4431 MS Primary

Addresses

Primary practice location

524 Lakeview CV
Ridgeland, MS 39157-1117

Mailing address

524 Lake View Cove
Ridgeland, MS 39157
Phone (601) 259-4710

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

LicenseStateTypeSpecialty
PTA4431MSMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1322697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1265700579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 LAKE VIEW COVE",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "39157",
            "telephone_number": "601-259-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 LAKEVIEW CV",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391571117",
            "telephone_number": "601-259-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "NANCY",
        "middle_name": "PHILLIPS",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-01",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "PTA4431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; 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.