Individual provider Active NPI

Thomas Davison

  • Professional Counselor
  • Shreveport, LA
National Provider Identifier
1497199459
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5752 Issued in LA
Practice address
8873 Quimper PL
Shreveport, LA 71105-5620
Phone
(318) 686-0012
Fax
(318) 686-0012
NPI assigned
Apr 22, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0082561 NM
Professional Counselor 101YP2500X 5752 LA Primary
Professional Counselor 101YP2500X 0158731 NM

Addresses

Primary practice location

8873 Quimper PL
Shreveport, LA 71105-5620

Mailing address

8873 Quimper PL
Shreveport, LA 71105-5620
Phone (318) 686-0012

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

State licenses

LicenseStateTypeSpecialty
0082561NMMDMental Health Counselor
5752LAMDProfessional Counselor
0158731NMMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Solutions, Inc. Professional 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": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381363200000",
    "number": "1497199459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8873 QUIMPER PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055620",
            "telephone_number": "318-686-0012",
            "fax_number": "318-686-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8873 QUIMPER PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055620",
            "telephone_number": "318-686-0012",
            "fax_number": "318-686-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-22",
        "last_updated": "2013-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0082561",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "5752",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "0158731",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; 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.