Connie Kaye Davis, BA, MHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

807 Madison St
Oregon, IL 61061-1735

Phone

(815) 440-5895

Fax

(815) 284-6599

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

Yes

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 IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sinnissippi Centers IncGroup PAC ID 3476459876, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts

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.

• Sinnissippi Centers, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rochelle, IL
  • NPI 1407143837
  Medicare reassignment Care Compare group NPD
• Sinnissippi Centers, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Carroll, IL
  • NPI 1366739781
  NPD
• Sinnissippi Centers, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Dixon, IL
  • NPI 1538447313
  NPD

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598883902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 MADISON ST",
            "city": "OREGON",
            "state": "IL",
            "postal_code": "610611609",
            "telephone_number": "815-440-5895",
            "fax_number": "815-284-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 MADISON ST",
            "city": "OREGON",
            "state": "IL",
            "postal_code": "610611735",
            "telephone_number": "815-440-5895",
            "fax_number": "815-284-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CONNIE",
        "middle_name": "KAYE",
        "name_prefix": "Ms.",
        "credential": "BA, MHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Couch to Couch Counseling
• County of Ogle
• John Brian Crisham, D.M.D.
• Krane T Cupples, D.C.
• Jill Davis-Kuzmanich
• David R Deforest, DDS
• Jessica Devries, B.A., MHP
• Dr Katherine Bailey DPM PC
• Rebecca Duke
• Sheri Dvorak, LMT, BCTMB

• Mental Health Counselor in Oregon, IL
• Providers in Oregon, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.