Active NPI
Thomas Davis, P.T.
- Physical Therapist
- Raleigh, NC
National Provider Identifier
1558393140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6849
- Practice address
- 1520 Sunday Dr
Suite 105
Raleigh, NC 27607-5253 - Phone
- (919) 420-1682
- Fax
- (919) 719-3531
- NPI assigned
- Jul 6, 2006
- Last updated
- Mar 4, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6849 | NC | Primary |
| Physical Therapist | 225100000X | PT26341 | FL | |
| Neurology Physical Therapist | 2251N0400X | 6849 | NC |
Addresses
Primary practice location
1520 Sunday Dr
Suite 105
Raleigh, NC 27607-5253
Mailing address
1520 Sunday Dr
Suite 105
Raleigh, NC 27607-5253
Phone (919) 420-1682
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891168N | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6849 | NC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bay State Physical Therapy PC | Physical Therapist | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Attleboro, MA
- NPI 1194387191
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362355200000",
"number": "1558393140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1520 SUNDAY DR",
"address_2": "SUITE 105",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276075253",
"telephone_number": "919-420-1682",
"fax_number": "919-719-3531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 SUNDAY DR",
"address_2": "SUITE 105",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276075253",
"telephone_number": "919-420-1682",
"fax_number": "919-719-3531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2013-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "6849",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT26341",
"primary": false
},
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": "NC",
"license": "6849",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891168N",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.