Carmen Davis

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S2996 Issued in MS

Practice address

103 Fox Chase Dr
Hattiesburg, MS 39402-2575

Phone

(601) 264-8828

NPI assigned

Feb 10, 2020

Last updated

Feb 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Performance Therapy LLCGroup PAC ID 7012971047, 86 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Performance Therapy LLC

  • Physical Therapist
  • Philadelphia, MS
  • NPI 1851427132
  Medicare reassignment Care Compare group
• Aultman Speech Therapy Services, LLC

  • Speech-Language Pathologist
  • Sumrall, MS
  • NPI 1912154220
  NPD (past)

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1457983249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 AVIGNON DR",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575120",
            "telephone_number": "601-605-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 FOX CHASE DR",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394022575",
            "telephone_number": "601-264-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CARMEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S2996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David M. Perez, DMD, P.C.
• Susan K Davidson, MS, LMFT
• Shannon Davis Sims
• Allyson Davis
• Angela Anita Davis, MSN, RN
• Chad Joseph Davis, MS, ATC
• Clifton H Davis, P.A.-C
• Colton Davis
• Deborah Leigh Davis, PHARMD
• John Davis

• Speech-Language Pathologist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.