Individual provider Active NPI

Garet S Davis, D.C.

  • Sports Physician Chiropractor
  • Alta Loma, CA
National Provider Identifier
1356658264
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
3473 Issued in TN
Practice address
9480 Baseline Rd
Alta Loma, CA 91701-5822
Phone
(909) 285-4561
NPI assigned
Sep 13, 2010
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 33635 CA
Sports Physician Chiropractor 111NS0005X 3473 TN Primary

Addresses

Primary practice location

9480 Baseline Rd
Alta Loma, CA 91701-5822

Mailing address

109 International Dr Ste 200
Franklin, TN 37067-1763
Phone (615) 271-2757

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220218001324 TN Practitioner - Chiropractic 8123389913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

109 International Dr
Suite 200
Franklin, TN 37067-1763
Phone (615) 271-2757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33635CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Davis Chiropractic PC Chiropractor CurrentSince Jul 24, 2022 Accepting new patients
Davis Chiropractic, P.C. Sports Physician CurrentSince Jan 3, 2022 Accepting new patients

Locations

9480 Base Line Rd
Alta Loma, CA 91701
Phone (909) 285-4561

109 International Dr
Ste 200
Franklin, TN 37067
Phone (615) 271-2757

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356658264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 INTERNATIONAL DR STE 200",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370671763",
            "telephone_number": "615-271-2757",
            "fax_number": "629-230-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9480 BASELINE RD",
            "city": "ALTA LOMA",
            "state": "CA",
            "postal_code": "917015822",
            "telephone_number": "909-285-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GARET",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-13",
        "last_updated": "2022-07-21",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "33635",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "TN",
            "license": "3473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alta Loma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.