Active NPI
Roy Clarence Davis
- Clinical Psychologist
- Kansas City, MO
National Provider Identifier
1417077330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 00978
- Practice address
- 8080 Ward Pkwy
Suite 140
Kansas City, MO 64114-2034 - Phone
- (816) 444-7688
- Fax
- (816) 444-0290
- NPI assigned
- Apr 2, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 00978 | MO | Primary |
Addresses
Primary practice location
8080 Ward Pkwy
Suite 140
Kansas City, MO 64114-2034
Mailing address
8080 Ward Pkwy
Suite 140
Kansas City, MO 64114-2034
Phone (816) 444-7688
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060265 | Other | MO | VALUEOPTIONS |
| 0004409354 | Other | MO | AETNA |
| 09686025 | Other | MO | BLUECROSSBLUESHIELD |
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 |
|---|---|---|---|
| 00978 | MO | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Psychiatric Consultants, P.C. | Past | Accepting new patients | |
| Dr. Roy C. Davis, P.C. | Clinical | Past | Accepting new patients |
| Kansas City University | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Kansas City, MO
- NPI 1265650717
-
- Specialist
- Lee's Summit, MO
- NPI 1265472088
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417077330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8080 WARD PKWY",
"address_2": "SUITE 140",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641142034",
"telephone_number": "816-444-7688",
"fax_number": "816-444-0290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8080 WARD PKWY",
"address_2": "SUITE 140",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641142034",
"telephone_number": "816-444-7688",
"fax_number": "816-444-0290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ROY",
"middle_name": "CLARENCE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "00978",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS",
"identifier": "060265",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0004409354",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSSBLUESHIELD",
"identifier": "09686025",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.