Active NPI
Wesley C Davis, DPT
- Physical Therapist
- Conneautville, PA
National Provider Identifier
1487921813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT021260
- Practice address
- 9108 State Highway 198
Conneautville, PA 16406-2646 - Phone
- (814) 587-2012
- Fax
- (814) 587-2350
- NPI assigned
- Nov 30, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT021260 | PA | Primary |
Addresses
Primary practice location
9108 State Highway 198
Conneautville, PA 16406-2646
Mailing address
12940 Hatch Hill Rd
Meadville, PA 16335-6002
Phone (814) 282-0589
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT021260 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445299200000",
"number": "1487921813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12940 HATCH HILL RD",
"city": "MEADVILLE",
"state": "PA",
"postal_code": "163356002",
"telephone_number": "814-282-0589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9108 STATE HIGHWAY 198",
"city": "CONNEAUTVILLE",
"state": "PA",
"postal_code": "164062646",
"telephone_number": "814-587-2012",
"fax_number": "814-587-2350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "WESLEY",
"middle_name": "C",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-30",
"last_updated": "2015-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT021260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conneautville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.