Active NPI
Jeffrey V Davis
- Orthotic Fitter
- Kalamazoo, MI
National Provider Identifier
1396971859
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotic Fitter
- License
- CPED2005
- Practice address
- 1016 E Cork St
Kalamazoo, MI 49001-4823 - Phone
- (269) 349-2247
- NPI assigned
- Jun 10, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | CPED2005 | MI | Primary |
Addresses
Primary practice location
1016 E Cork St
Kalamazoo, MI 49001-4823
Mailing address
3061 Christy Way
Saginaw, MI 48603-2267
Phone (989) 791-2455
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 |
|---|---|---|---|
| CPED2005 | MI | MD | Orthotic Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kalamazoo Orthotics & Diabetic Shoes Inc | Past | Accepting new patients | |
| Kalamazoo Shoe Company, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Kalamazoo, MI
- NPI 1336386358
-
- Prosthetic/Orthotic Supplier
- Kalamazoo, MI
- NPI 1497812002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244592000000",
"number": "1396971859",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3061 CHRISTY WAY",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486032267",
"telephone_number": "989-791-2455",
"fax_number": "989-791-1392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 E CORK ST",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490014823",
"telephone_number": "269-349-2247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JEFFREY",
"middle_name": "V",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-10",
"last_updated": "2009-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": "MI",
"license": "CPED2005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.