Active NPI
Travis Dale Davis, DPT
- Physical Therapist
- Greenwood, AR
National Provider Identifier
1407398605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P17776
- Practice address
- 1515 W Center St
Greenwood, AR 72936-3423 - Phone
- (479) 252-1989
- NPI assigned
- Nov 6, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1276171 | TX | |
| Physical Therapist | 225100000X | P17776 | NC | Primary |
| Physical Therapist | 225100000X | 4129 | AR |
Addresses
Primary practice location
1515 W Center St
Greenwood, AR 72936-3423
Mailing address
116 Staffordshire Drive
Statesville, NC 28625
Phone (479) 252-1989
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 |
|---|---|---|---|
| P17776 | NC | MD | Physical Therapist |
| 1276171 | TX | MD | Physical Therapist |
| 4129 | AR | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754611200000",
"number": "1407398605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "116 STAFFORDSHIRE DRIVE",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "28625",
"telephone_number": "479-252-1989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 W CENTER ST",
"city": "GREENWOOD",
"state": "AR",
"postal_code": "729363423",
"telephone_number": "479-252-1989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "TRAVIS",
"middle_name": "DALE",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-11-06",
"last_updated": "2025-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1276171",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P17776",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "4129",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.