Ryan Taylor Davidson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT4752 Issued in AR

Practice address

101 E Emma Ave
Springdale, AR 72764-4623

Phone

(479) 334-5616

Fax

(479) 334-5617

NPI assigned

Dec 17, 2019

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 AR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premiere Physical Therapy and Sports Rehab LLCGroup PAC ID 9234236183, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Premiere Physical Therapy and Sports Rehab LLC

  • Physical Therapy Clinic/Center
  • Bentonville, AR
  • NPI 1134258981

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Serc Rehabilitation Partners, LLC

  • Physical Therapist
  • Belton, MO
  • NPI 1760745244

  AR

  Medicare reassignment NPD
• Serc Rebabilitation Partners, LLC

  • Physical Therapist
  • Overland Park, KS
  • NPI 1598190209
  NPD

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

{
    "created_epoch": "1576540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1508404872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E EMMA AVE",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727644623",
            "telephone_number": "479-334-5616",
            "fax_number": "479-334-5617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "RYAN",
        "middle_name": "TAYLOR",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-17",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT4752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Landon Daniel, PHARM.D.
• Michael Daniel, LPN
• Jamie Daniels, PTA
• Leah Dianne Davenport, PTA
• David R Massey MD PLLC
• Trudy Mae Davidson, PTA
• Latandria Davie
• Jacob Thomas Davies, PT, DPT
• Daniel Davis, NP-C
• David A Davis, M.D.

• Physical Therapist in Springdale, AR
• Providers in Springdale, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.