Individual provider Active NPI

Denise N Davis, LMP

  • Specialist
  • Mount Vernon, WA
National Provider Identifier
1477877413
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00016641 Issued in WA
Practice address
1601 William Way Ste a
Mount Vernon, WA 98273-2500
Phone
(360) 424-8115
Fax
(360) 428-0104
NPI assigned
Mar 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00016641 WA Primary

Addresses

Primary practice location

1601 William Way Ste a
Mount Vernon, WA 98273-2500

Mailing address

1601 William Way Ste a
Mount Vernon, WA 98273-2500
Phone (360) 424-8115

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
Credentials
Master of Theology

State licenses

LicenseStateTypeSpecialty
MA00016641WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Chiropractic Clinic PS Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1477877413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 WILLIAM WAY STE A",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732500",
            "telephone_number": "360-424-8115",
            "fax_number": "360-428-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WILLIAM WAY STE A",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732500",
            "telephone_number": "360-424-8115",
            "fax_number": "360-428-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DENISE",
        "middle_name": "N",
        "credential": "LMP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00016641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2010; 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.