Individual provider Active NPI

Doni Beth Davis, D.C.

  • Chiropractor
  • Kenosha, WI
National Provider Identifier
1306081658
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4455 Issued in WI
Practice address
3720 - 72ND Avenue
Kenosha, WI 53144
Phone
(262) 764-9301
Fax
(262) 764-9303
NPI assigned
Dec 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4455-012 WI
Chiropractor 111N00000X 4455 WI Primary

Addresses

Primary practice location

3720 - 72ND Avenue
Kenosha, WI 53144

Mailing address

3720 72ND Avenue
Kenosha, WI 53144
Phone (262) 764-9301

Other names 1

  • Doni Beth Daniels Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090205000283 WI Practitioner - Chiropractic 1254495278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1711 Green Bay Rd
Suite C
Kenosha, WI 53144-1250
Phone (262) 764-9301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4455-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Sozo Chiropractic CurrentSince May 19, 2014 Accepting new patients
Daniels Chiropractic Office Inc PastSince Jan 2, 2008 Accepting new patients
Chiropractic Company - Mke Downtown LTD Chiropractor Past Accepting new patients

Locations

1711 Green Bay Rd
Ste C
Kenosha, WI 53144
Phone (262) 764-9301

3720 72nd Ave
Kenosha, WI 53144
Phone (262) 764-9301

Organizations & group practices 3

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": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1306081658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 72ND AVENUE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53144",
            "telephone_number": "262-764-9301",
            "fax_number": "262-764-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 - 72ND AVENUE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "53144",
            "telephone_number": "262-764-9301",
            "fax_number": "262-764-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DONI",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-15",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4455-012",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONI",
            "last_name": "DANIELS",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kenosha, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.