Benjamin Drew Davis, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000018226 Issued in MS

Practice address

1200 Magnolia Way
Blue Springs, MS 38828-6000

Phone

(662) 317-3229

Fax

(662) 317-3216

NPI assigned

Mar 14, 2018

Last updated

Mar 14, 2018By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1518460740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 CONFEDERATE AVE",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014104",
            "telephone_number": "662-397-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MAGNOLIA WAY",
            "city": "BLUE SPRINGS",
            "state": "MS",
            "postal_code": "388286000",
            "telephone_number": "662-317-3229",
            "fax_number": "662-317-3216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BENJAMIN",
        "middle_name": "DREW",
        "name_prefix": "Mr.",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": "2000018226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda L Frederick, LCSW
• Kelli Hutcheson Greer, OTR/L
• Victoria Kilpatrick, LCSW
• Andrew McDonald
• Premise Health of Mississippi Medical PC (Toyota Family Health Center)

• Athletic Trainer in Blue Springs, MS
• Providers in Blue Springs, MS by specialty
• Athletic Trainer in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; 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.