Jeffery Alan Davis
Individual provider Active NPI Attendant Care Provider · North, VA
NPI 1366091563 · NPPES record last updated Sep 10, 2019
Key facts
- NPI
- 1366091563
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Attendant Care Provider 3747A0650X
- Practice address
- 615 Plantation Rd
North, VA 23128-2021 - Phone
- (804) 815-2350
- NPI assigned
- Sep 10, 2019
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | Yes |
Addresses
Primary practice location
615 Plantation Rd
North, VA 23128-2021
Mailing address
615 Plantation Rd
North, VA 23128-2021
Phone (804) 815-2350
Other providers in North, VA
All providers in North, VA · Attendant Care Provider in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.