Active NPI
Andrew S. Davis, PHD
- Psychologist
- Indianapolis, IN
National Provider Identifier
1275580102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 20041988A
- Practice address
- 2001 W 86TH St
Indianapolis, IN 46260-1902 - Phone
- (317) 338-3103
- NPI assigned
- May 27, 2006
- Last updated
- Aug 2, 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 20041988A | IN | |
| Psychologist | 103T00000X | 20041988A | IN | Primary |
| School Psychologist | 103TS0200X | 20041988A | IN | |
| Clinical Psychologist | 103TC0700X | 20041988A | IN |
Addresses
Primary practice location
2001 W 86TH St
Indianapolis, IN 46260-1902
Mailing address
9588 Valparaiso CT
Indianapolis, IN 46268-1130
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20041988A | IN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Neuropsychology Associates | Clinical Neuropsychologist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Neuropsychologist
- Indianapolis, IN
- NPI 1922011089
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186012800000",
"number": "1275580102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9588 VALPARAISO CT",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462681130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 W 86TH ST",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462601902",
"telephone_number": "317-338-3103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ANDREW",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-27",
"last_updated": "2007-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "IN",
"license": "20041988A",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IN",
"license": "20041988A",
"primary": true
},
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "IN",
"license": "20041988A",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20041988A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.