Active NPI
Willie Michael Davis, HEARING AID DISPENSE
- Hearing Instrument Specialist
- Cottage Grove, OR
National Provider Identifier
1407157266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- HASP10135362
- Practice address
- 1498 E Main St
Suite No. 108
Cottage Grove, OR 97424-2204 - Phone
- (541) 942-8444
- NPI assigned
- Nov 10, 2010
- 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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | HASP10135362 | OR | Primary |
Addresses
Primary practice location
1498 E Main St
Suite No. 108
Cottage Grove, OR 97424-2204
Mailing address
1498 E Main St
Suite No. 108
Cottage Grove, OR 97424-2204
Phone (541) 942-8444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HASP10135362 | Other | OR | OREGON LICENSE NUMBER |
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 |
|---|---|---|---|
| HASP10135362 | OR | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289347200000",
"number": "1407157266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1498 E MAIN ST",
"address_2": "SUITE NO. 108",
"city": "COTTAGE GROVE",
"state": "OR",
"postal_code": "974242204",
"telephone_number": "541-942-8444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1498 E MAIN ST",
"address_2": "SUITE NO. 108",
"city": "COTTAGE GROVE",
"state": "OR",
"postal_code": "974242204",
"telephone_number": "541-942-8444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "WILLIE",
"middle_name": "MICHAEL",
"credential": "HEARING AID DISPENSE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-10",
"last_updated": "2010-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "OR",
"license": "HASP10135362",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON LICENSE NUMBER",
"identifier": "HASP10135362",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cottage Grove, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.