Individual provider Active NPI

Christopher Davis

  • Marriage & Family Therapist
  • Louisville, KY
National Provider Identifier
1508294430
Registry record updated Nov 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
09-019 Issued in KY
Practice address
5106 Outer Loop
Louisville, KY 40219-4056
Phone
(502) 645-6026
NPI assigned
Nov 1, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 09-019 KY Primary

Addresses

Primary practice location

5106 Outer Loop
Louisville, KY 40219-4056

Mailing address

5106 Outer Loop
Louisville, KY 40219-4056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20250218001759 KY Practitioner - Marriage and Family Therapist 4183144454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

119 S Sherrin Ave
Suite 240
Louisville, KY 40207-3237
Phone (502) 509-6002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09-019KYMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mindive Marriage & Family Therapist Current Accepting new patients
Mindive Marriage & Family Therapist CurrentSince Dec 1, 2024 Accepting new patients

Locations

119 S Sherrin Ave
Ste 240
Louisville, KY 40207
Phone (502) 509-6002

Organizations & group practices 2

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": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383264000000",
    "number": "1508294430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5106 OUTER LOOP",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402194056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5106 OUTER LOOP",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402194056",
            "telephone_number": "502-645-6026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-01",
        "last_updated": "2013-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "09-019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.