Courtney Nichole Davis, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

6921 Issued in MS

Practice address

13 Northtown Dr Ste 110
Jackson, MS 39211-3047

Phone

(601) 206-9195

NPI assigned

Mar 22, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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 and National Provider Directory roles.

• Trinity Rehabilitation Inc

  • Physical Therapist
  • Jackson, MS
  • NPI 1588759369

  Physical Therapy Assistant

  NPD (past)

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1366028292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 CLUBHOUSE DR",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392089506",
            "telephone_number": "662-372-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 NORTHTOWN DR STE 110",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392113047",
            "telephone_number": "601-206-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "COURTNEY",
        "middle_name": "NICHOLE",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MS",
            "license": "6921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE INSURANCE",
            "identifier": "6921",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "trinityrehabms@aol.com",
            "affiliation": "N",
            "address_1": "13 Northtown Dr Ste 110",
            "city": "Jackson",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392113047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bobbie Davis, NCC, PLPC, BC-TMH
• Brad Davis
• Catherine Davis, C.S.A.
• Charles Rosa Davis, DDS
• Christy L Davis, FNP
• Courtney Strong Davis, PHARM.D.
• Dana Arender Davis, FNP-C
• Deborah Gay Davis
• Dereck Davis
• Derrick Dewayner Davis

• Physical Therapy Assistant in Jackson, MS
• Providers in Jackson, MS by specialty
• Physical Therapy Assistant in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.