Individual provider Active NPI

Tyrone Davis

  • Non-emergency Medical Transport (VAN)
  • Chicago, IL
National Provider Identifier
1447965124
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Practice address
1937 S Spaulding Ave
Chicago, IL 60623-2616
Phone
(773) 988-8750
NPI assigned
Jan 18, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X
Non-emergency Medical Transport (VAN) 343900000X IL Primary

Addresses

Primary practice location

1937 S Spaulding Ave
Chicago, IL 60623-2616

Mailing address

1937 S Spaulding Ave
Chicago, IL 60623-2616
Phone (773) 988-8750

Other practice location 1

1937 S Spaulding Ave
Chicago, IL 60623-2616
Phone (773) 988-8750

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

NPI Registry JSON

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1447965124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1937 S SPAULDING AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232616",
            "telephone_number": "773-988-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1937 S SPAULDING AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232616",
            "telephone_number": "773-988-8750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1937 S Spaulding Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606232616",
            "country_code": "US",
            "telephone_number": "773-988-8750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TYRONE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.