Individual provider Active NPI

Paul W Davis, PH.D.

  • Clinical Psychologist
  • Tuscaloosa, AL
National Provider Identifier
1487674669
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
856 Issued in AL
Practice address
701 University Blvd E
Suite 204
Tuscaloosa, AL 35401-2086
Phone
(205) 758-7343
Fax
(205) 553-9127
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 856 AL Primary

Addresses

Primary practice location

701 University Blvd E
Suite 204
Tuscaloosa, AL 35401-2086

Mailing address

PO Box 1046
Northport, AL 35476-6046
Phone (205) 758-7343

Other identifiers 1

IdentifierTypeStateIssuer
51032243OtherALBCBS

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
856ALMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Davis & Davis, Clinical Psychologists, PC Clinical 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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1487674669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1046",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354766046",
            "telephone_number": "205-758-7343",
            "fax_number": "205-553-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 UNIVERSITY BLVD E",
            "address_2": "SUITE 204",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354012086",
            "telephone_number": "205-758-7343",
            "fax_number": "205-553-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "PAUL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51032243",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.