Caitlin Davis

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

63021264 Issued in NY

Practice address

159 W 1St St
Oswego, NY 13126

Phone

(315) 342-9575

Fax

(315) 342-7664

NPI assigned

Feb 22, 2017

Last updated

Jan 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Caitlin Coughlin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1427597475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 HICKORY HOLLOW DR",
            "city": "PALENVILLE",
            "state": "NY",
            "postal_code": "124632619",
            "telephone_number": "518-965-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 W 1ST ST",
            "city": "OSWEGO",
            "state": "NY",
            "postal_code": "13126",
            "telephone_number": "315-342-9575",
            "fax_number": "315-342-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CAITLIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "021264-1",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": "63021264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05202997",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "COUGHLIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carlos Oblena Dator, MD
• Melissa Virginia Dauccio
• David a Vecchio, LMSW Counseling Services PC
• David J. Dexter, O.D., P.C.
• Maureen Susan David, OTRL
• Cynthia Sue Davis, P.T.A.
• Jill R Davis, MS, OTR/L
• Laura Beth Davis, COTA
• Sandra G Davis, SLP
• Dawn Metott, Mental Health Counselor, PLLC

• Case Manager/Care Coordinator in Oswego, NY
• Providers in Oswego, NY by specialty
• Case Manager/Care Coordinator in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.