Shawan Davis

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Practice address

6700 Bowden Road Unit 1104
Jacksonville, FL 32216

Phone

(904) 415-7665

NPI assigned

Feb 8, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Impact Home Care Services LLC

  • Developmentally Disabled Services Day Training Agency
  • Jacksonville, FL
  • NPI 1215682505

  Day Training, Developmentally Disabled Services

  NPD Authorized official

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1306590385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 BOWDEN RD UNIT 1104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163672",
            "telephone_number": "904-415-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 BOWDEN ROAD UNIT 1104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-415-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHAWAN",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "813927678",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Davis
• Scott Lee Davis, M.D.
• Sean Morgan Davis, MD
• Shanika Niquan Davis, OTR/L
• Shannon Rene' Davis, M.ED., CCC-SLP
• Sheldon Davis Jr.
• Stacey Michel Davis, ARNP, FNP-BC
• Thomas S Davis, MD
• Travis M Davis
• Trevaine A Davis, PA

• Developmentally Disabled Services Day Training Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.