Davis Integrated Medicine LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00206300 Issued in NJ

Legal business name

DAVIS INTEGRATED MEDICINE LLC

Practice address

309 Orange Rd
Montclair, NJ 07042-4451

Phone

(973) 839-1003

Fax

(973) 839-3653

NPI assigned

Sep 27, 2013

Organization subpart

No

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

Authorized official

Name

Alfred Davis, DC

Title

Ownerq

Phone

(973) 839-1003

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1285061838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 ORANGE RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424451",
            "telephone_number": "973-839-1003",
            "fax_number": "973-839-3653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 ORANGE RD",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424451",
            "telephone_number": "973-839-1003",
            "fax_number": "973-839-3653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS INTEGRATED MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "OWNERQ",
        "authorized_official_telephone_number": "973-839-1003",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00206300",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "38MC00206300",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NJ",
            "license": "38MC00206300",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mario Dartayet-Rodriguez, LCSW, CSAT
• Andreia Dasilva, LCSW
• Ayana Najwa Dasilva, LCSW
• Michael Davidson, DMD
• Davis Chiropractic Center LLC
• Davis Integrated Medicine LLC
• John L Davis, MS, ATC
• Krystle M Davis
• Dawn Romeo LCSW,Lcadc,LLC
• Sandy Dawoud, PHD

• Chiropractor in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.