Active NPI
Sally Jean Davis, OT
- Gerontology Occupational Therapist
- Weatherford, TX
National Provider Identifier
1386126027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Occupational Therapist
- License
- 109461
- Practice address
- 1201 Holland Lake Dr
Weatherford, TX 76086-5851 - Phone
- (817) 598-0162
- NPI assigned
- Aug 29, 2018
- Last updated
- Aug 29, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Gerontology Occupational Therapist | 225XG0600X | 109461 | TX | Primary |
Addresses
Primary practice location
1201 Holland Lake Dr
Weatherford, TX 76086-5851
Mailing address
2813 Weber St
Fort Worth, TX 76106-7340
Phone (817) 223-9544
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 |
|---|---|---|---|
| 109461 | TX | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535500800000",
"number": "1386126027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2813 WEBER ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761067340",
"telephone_number": "817-223-9544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 HOLLAND LAKE DR",
"city": "WEATHERFORD",
"state": "TX",
"postal_code": "760865851",
"telephone_number": "817-598-0162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "SALLY",
"middle_name": "JEAN",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-29",
"last_updated": "2018-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225XG0600X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Gerontology",
"state": "TX",
"license": "109461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weatherford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.