Individual provider Active NPI

James E Davis, M.S, OTR/L

  • Occupational Therapist
  • Temecula, CA
National Provider Identifier
1619144375
Registry record updated Feb 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4120 Issued in AZ
Practice address
41743 Enterprise Cir N
Suite #107
Temecula, CA 92590-5645
Phone
(951) 302-0278
Fax
(951) 266-5759
NPI assigned
May 13, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 4120 AZ Primary

Addresses

Primary practice location

41743 Enterprise Cir N
Suite #107
Temecula, CA 92590-5645

Mailing address

33964 Lydia CT
Temecula, CA 92592-9140
Phone (480) 789-2980

Other identifiers 3

IdentifierTypeStateIssuer
13729OtherCASTATE OF CALIFORNIA
4120OtherAZARIZONA LICENSE
CA138726OtherCAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040727000811 CA Practitioner - Occupational Therapist in Private Practice 4789654948 Reassigns benefits to 1 organization
I20080801000138 AZ Practitioner - Occupational Therapist in Private Practice 4789654948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zoe Health Group LLCGroup PAC ID 2062887607, 2 clinicians

Practice addresses (Care Compare)

3530 S Val Vista Dr
Suite A111
Gilbert, AZ 85297-7319
Phone (480) 608-0058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4120AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Zoe Health Group LLC CurrentSince Aug 26, 2023 Accepting new patients
Neuro Rehab Connection CurrentSince Jul 8, 2014 Accepting new patients
Rehab Arizona Neuro Rehabilitation, LLC Past Accepting new patients

Locations

3530 S Val Vista Dr
Ste A111
Gilbert, AZ 85297
Phone (480) 219-7810

31309 Temecula Pkwy
Ste 101
Temecula, CA 92592
Phone (951) 302-5213

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1210636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424390400000",
    "number": "1619144375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33964 LYDIA CT",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925929140",
            "telephone_number": "480-789-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41743 ENTERPRISE CIR N",
            "address_2": "SUITE #107",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925905645",
            "telephone_number": "951-302-0278",
            "fax_number": "951-266-5759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAMES",
        "middle_name": "E",
        "credential": "M.S, OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-13",
        "last_updated": "2015-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "4120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CALIFORNIA",
            "identifier": "13729",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA LICENSE",
            "identifier": "4120",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CA138726",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.