Individual provider Active NPI

Rachel Shayna Davis, LCSW-C

  • Clinical Social Worker
  • Gaithersburg, MD
National Provider Identifier
1285056812
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19327 Issued in MD
Practice address
16220 Frederick Rd
Suite 310
Gaithersburg, MD 20877-4039
Phone
(301) 345-1022
Fax
(301) 560-5558
NPI assigned
Jan 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 19327 MD Primary

Addresses

Primary practice location

16220 Frederick Rd
Suite 310
Gaithersburg, MD 20877-4039

Mailing address

7474 Greenway Center Dr
Suite 730
Greenbelt, MD 20770-3504
Phone (301) 345-1022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180102001722 MD Practitioner - Clinical Social Worker 3779841374 Reassigns benefits to 1 organization
I20190701001711 DC Practitioner - Clinical Social Worker 3779841374 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19327MDMDPharmacist

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.

NPI Registry JSON

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

{
    "created_epoch": "1389830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433808000000",
    "number": "1285056812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7474 GREENWAY CENTER DR",
            "address_2": "SUITE 730",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703504",
            "telephone_number": "301-345-1022",
            "fax_number": "301-560-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16220 FREDERICK RD",
            "address_2": "SUITE 310",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774039",
            "telephone_number": "301-345-1022",
            "fax_number": "301-560-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RACHEL",
        "middle_name": "SHAYNA",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-16",
        "last_updated": "2015-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "19327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.