Active NPI
Patricia Shields Davis
- Clinical Social Worker
- Ellicott City, MD
National Provider Identifier
1366036287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 12981
- Practice address
- 5136 Dorsey Hall Dr # DR2
Ellicott City, MD 21042-7921 - Phone
- (410) 591-3864
- NPI assigned
- Feb 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 12981 | MD | Primary |
Addresses
Primary practice location
5136 Dorsey Hall Dr # DR2
Ellicott City, MD 21042-7921
Mailing address
2460 Sophia Chase Dr
Marriottsville, MD 21104-1495
Phone (410) 591-3864
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 |
|---|---|---|---|
| 12981 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613952000000",
"number": "1366036287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2460 SOPHIA CHASE DR",
"city": "MARRIOTTSVILLE",
"state": "MD",
"postal_code": "211041495",
"telephone_number": "410-591-3864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5136 DORSEY HALL DR # DR2",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210427921",
"telephone_number": "410-591-3864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "PATRICIA",
"middle_name": "SHIELDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-22",
"last_updated": "2021-02-22",
"certification_date": "2021-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "12981",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.