Active NPI
Charles Brian Davis, ATC, ROT, EMR
- Athletic Trainer
- Birmingham, AL
National Provider Identifier
1417054065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 771
- Practice address
- 3525 Independence Dr
Birmingham, AL 35209-5709 - Phone
- (205) 802-6700
- Fax
- (205) 802-6701
- NPI assigned
- Sep 17, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 771 | AL | Primary |
| Surgical Technologist | 246ZS0410X |
Addresses
Primary practice location
3525 Independence Dr
Birmingham, AL 35209-5709
Mailing address
263 Parkview Dr
Sylvan Springs, AL 35118-9719
Phone (205) 410-0139
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 |
|---|---|---|---|
| 771 | AL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266192000000",
"number": "1417054065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 PARKVIEW DR",
"city": "SYLVAN SPRINGS",
"state": "AL",
"postal_code": "351189719",
"telephone_number": "205-410-0139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3525 INDEPENDENCE DR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352095709",
"telephone_number": "205-802-6700",
"fax_number": "205-802-6701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "CHARLES",
"middle_name": "BRIAN",
"name_prefix": "Mr.",
"credential": "ATC, ROT, EMR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-17",
"last_updated": "2010-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AL",
"license": "771",
"primary": true
},
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.