Taylor Damian Davis

Primary specialty

OptometristTaxonomy code 152W00000X

License

3724 Issued in MN

Practice address

971 County Road E E
Vadnais Heights, MN 55127-7114

Phone

(651) 877-1009

Fax

(651) 666-2974

NPI assigned

May 27, 2021

Last updated

May 27, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shoptikal LLCGroup PAC ID 1456684471, 192 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Shoptikal LLC

  dba Shopko Optical 4002

  • Eyewear Supplier
  • Green Bay, WI
  • NPI 1659937159

  Optometrist

  Medicare reassignment Care Compare group NPD
• Shoptikal LLC

  dba Shopko Optical 4226

  • Eyewear Supplier
  • Sun Prairie, WI
  • NPI 1578170247

  Optometrist

  NPD

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1306411731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10411 GRAND VALLEY LN",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551294261",
            "telephone_number": "702-843-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 COUNTY ROAD E E",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551277114",
            "telephone_number": "651-877-1009",
            "fax_number": "651-666-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TAYLOR",
        "middle_name": "DAMIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "3724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steve Dahl, LICSW
• Amber Dahlheimer, LICSW
• Peter Kirk Dahlstrom, M.D.
• Danielle Golden, Crna, PA (The Remedy)
• John Preston Daniels, MD
• Stefania Rebecca De Bruin, PT
• Dawn M Debus, PA-C
• Zoey Arianna Dooley
• Kristin Rochelle Dorn
• Courtney Taylor Eddy, CNP

• Optometrist in Vadnais Heights, MN
• Providers in Vadnais Heights, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.