Antonio Tremon Davis, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

17337 Issued in SC

Practice address

3041 Old Eastover Rd
Eastover, SC 29044-8303

Phone

(803) 353-8741

NPI assigned

Jun 26, 2021

Last updated

Oct 23, 2024By the provider in NPPES

Sex

Male

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 SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eau Claire Cooperative Health Center, Inc.Group PAC ID 3274434220, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: antonio.davis.1@10781.direct.athenahealth.com

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.

• Eau Claire Cooperative Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1346249430
  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  SC

  Medicare reassignment NPD
• Eau Claire Cooperative Health Center ,Inc.

  dba Cooperative Health @ CAMH

  • Federally Qualified Health Center (FQHC)
  • Columbia, SC
  • NPI 1588375653
  NPD

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

{
    "created_epoch": "1624665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1497325195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3041 OLD EASTOVER RD",
            "city": "EASTOVER",
            "state": "SC",
            "postal_code": "290448303",
            "telephone_number": "803-353-8741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3041 OLD EASTOVER RD",
            "city": "EASTOVER",
            "state": "SC",
            "postal_code": "290448303",
            "telephone_number": "803-353-8741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ANTONIO",
        "middle_name": "TREMON",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-26",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "17337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zena Boyd
• BRK Psychiatric Mental Health Services LLC
• Colonial Family Practice, LLC (Colonial Family Practice Garners Ferry)
• Denise Faye Corpening, RN
• Courtlyn House CRCF
• Jerry Rena Delgado, CPHT
• Napoleon Deveaux
• Eau Claire Cooperative Health Center, Inc. (Eastover Cooperative Pharmacy)
• Eau Claire Cooperative Health Center, Inc. (Eastover Cooperative Pharmacy)
• Eau Claire Cooperative Health Center, Inc. (Eastover Family Practice)

• Clinical Social Worker in Eastover, SC
• Providers in Eastover, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.