Jerry Davis, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39001542A Issued in IN

Practice address

1530 Commerce Park West Drive
Greensburg, IN 47240

Phone

(812) 663-7057

Fax

(812) 378-8367

NPI assigned

Feb 2, 2006

Last updated

Apr 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1992781470
  Medicare reassignment NPD
• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1972320224
  NPD
• Quinco Consulting Center Inc

  dba Quinco Behavioral Health Systems

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greensburg, IN
  • NPI 1437280989
  NPD (past)

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1457323560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 N MARR RD",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472016660",
            "telephone_number": "812-314-3400",
            "fax_number": "812-378-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 COMMERCE PARK WEST DRIVE",
            "city": "GREENSBURG",
            "state": "IN",
            "postal_code": "47240",
            "telephone_number": "812-663-7057",
            "fax_number": "812-378-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JERRY",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39001542A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000321018",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Nicole Daeger
• Maria A Darr, M.D.
• Purnendu Prakish Datta, MD
• David a. Dickey, D.D.S., P.C. (Family Dental Care of Greensburg)
• David Anthony Noles Family Dental, LLC (Noles Family Dental)
• Katherine Davis
• Megan Davis
• DC Integrated Medicine Corporation
• Decatur County Community Schools
• Decatur County Health Department

• Mental Health Counselor in Greensburg, IN
• Providers in Greensburg, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.