Active NPI
Anthony Darnell Davis
- Behavior Technician
- Roxbury, MA
National Provider Identifier
1609465426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- S97538252
- Practice address
- 50 Catawba St
Roxbury, MA 02119-1825 - Phone
- (617) 756-0865
- NPI assigned
- Jan 15, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | S97538252 | MA | Primary |
Addresses
Primary practice location
50 Catawba St
Roxbury, MA 02119-1825
Mailing address
50 Catawba St
Roxbury, MA 02119-1825
Phone (161) 775-6086
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S97538252 | MA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610668800000",
"number": "1609465426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 CATAWBA ST",
"city": "ROXBURY",
"state": "MA",
"postal_code": "021191825",
"telephone_number": "161-775-6086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 CATAWBA ST",
"city": "ROXBURY",
"state": "MA",
"postal_code": "021191825",
"telephone_number": "617-756-0865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ANTHONY",
"middle_name": "DARNELL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-15",
"last_updated": "2021-01-15",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "MA",
"license": "S97538252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roxbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.