Active NPI
Augustus M Davis Jr., PT
- Specialist
- Eustis, FL
National Provider Identifier
1316154180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- PT20206
- Practice address
- 1301 S Bay St
Eustis, FL 32726-5550 - Phone
- (352) 357-5133
- Fax
- (352) 357-5460
- NPI assigned
- May 17, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | PT20206 | FL | Primary |
Addresses
Primary practice location
1301 S Bay St
Eustis, FL 32726-5550
Mailing address
1301 S Bay St
Eustis, FL 32726-5550
Phone (352) 357-5133
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT20206 | FL | MD | Specialist |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316154180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 S BAY ST",
"city": "EUSTIS",
"state": "FL",
"postal_code": "327265550",
"telephone_number": "352-357-5133",
"fax_number": "352-357-5460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 S BAY ST",
"city": "EUSTIS",
"state": "FL",
"postal_code": "327265550",
"telephone_number": "352-357-5133",
"fax_number": "352-357-5460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "AUGUSTUS",
"middle_name": "M",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "PT20206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eustis, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.