Individual provider Active NPI

Davis William Staley, DPT

  • Physical Therapist
  • Tucson, AZ
National Provider Identifier
1508539263
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1020 S Harrison Rd Ste 120
Tucson, AZ 85748-6610
Phone
(520) 822-8640
Fax
(520) 822-8641
NPI assigned
Jul 28, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1020 S Harrison Rd Ste 120
Tucson, AZ 85748-6610

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other practice location 1

46706 US Highway 41
Houghton, MI 49931-9021
Phone (440) 591-4015

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210909001103 WA Practitioner - Physical Therapist in Private Practice 8224434758 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apple Physical Therapy LLCGroup PAC ID 7810892072, 285 clinicians

Practice addresses (Care Compare)

17650 140TH Ave SE
Suite B7
Renton, WA 98058-6814
Phone (425) 430-0700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Physical Therapy LLC Physical Therapist CurrentSince Aug 23, 2021 Accepting new patients
Apple Physical Therapy, LLC Physical Therapist CurrentSince Aug 23, 2021 Accepting new patients
Ideal Rehabilitation LLC PastSince Jan 10, 2021 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

20821 Sr 410 E
Bonney Lake, WA 98391
Phone (253) 863-7510

4220 Hoyt Ave
Everett, WA 98203
Phone (425) 258-5330

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

32030 23rd Ave S
Federal Way, WA 98003
Phone (253) 946-4852

130 Marvin Rd SE
Ste 203
Lacey, WA 98503
Phone (360) 456-3300

6985 Coal Creek Pkwy SE
Newcastle, WA 98059
Phone (425) 378-0500

17650 140th Ave SE
Ste B7
Renton, WA 98058
Phone (425) 430-0700

2600 SW Barton St
Ste D3
Seattle, WA 98126
Phone (206) 573-5074

4701 41st Ave SW
Ste 100
Seattle, WA 98116
Phone (206) 338-2070

Organizations & group practices 3

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": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1508539263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S HARRISON RD STE 120",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857486610",
            "telephone_number": "520-822-8640",
            "fax_number": "520-822-8641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46706 US Highway 41",
            "address_purpose": "LOCATION",
            "city": "Houghton",
            "state": "MI",
            "postal_code": "499319021",
            "country_code": "US",
            "telephone_number": "440-591-4015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALEY",
        "first_name": "DAVIS",
        "middle_name": "WILLIAM",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-28",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.