Charisse Davis

Primary specialty

DriverTaxonomy code 172A00000X

License

W105050002 Issued in MO

Practice address

510 Main St
Waynesville, MO 65583-2031

Phone

(573) 889-7203

NPI assigned

Apr 28, 2020

Last updated

Apr 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Angels Care and Transportation

  • Home Health Aide
  • Waynesville, MO
  • NPI 1679072425
  NPD Authorized official

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1306467519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 MAIN ST",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655832031",
            "telephone_number": "573-889-8414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 MAIN ST",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655832031",
            "telephone_number": "573-889-7203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHARISSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "MO",
            "license": "134186B",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "MO",
            "license": "134186B",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "MO",
            "license": "134186B",
            "primary": false
        },
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "MO",
            "license": "W105050002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Lynn Cooper, M.A., PLPC
• Nathan Alec Crawshaw, PA-C
• Cross Creek Counseling Center, LLC
• CS Larson OD & Associates PC
• Stephanie Rose Cullen
• Lon 'Mark' Davis, LPC, NCC
• Kelsey Dethrow
• Denise Dickens, PLPC
• Jaclyn Michelle Ditt
• Divine Deliverance Counseling Center

• Driver in Waynesville, MO
• Providers in Waynesville, MO by specialty
• Driver in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; 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.