Cory S Davis, DC
Individual provider Active NPI Chiropractor · Martin, TN
NPI 1588080683 · NPPES record last updated Jul 14, 2018
Key facts
- NPI
- 1588080683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2758 (TN)
- Practice address
- 116 Masonic Dr
Martin, TN 38237 - Phone
- (731) 588-5144
- Fax
- (731) 588-5145
- NPI assigned
- Mar 13, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Performance Chiropractic
Practice addresses (Care Compare)
298 Broadway St
Martin, TN 38237-2482
Phone (731) 588-5144
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140520002610 | TN | Practitioner - Chiropractic | 2961625983 |
Reassigns benefits to 1 organization Practice locations: Martin, TN |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2758 | TN | MD | Pediatric Nutrition Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Performance Chiropractic | Chiropractor | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2758 | TN | Yes |
Addresses
Primary practice location
116 Masonic Dr
Martin, TN 38237
Mailing address
116 Masonic Dr
Martin, TN 38237-2400
Phone (731) 588-5144
Other providers in Martin, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.