Individual provider Active NPI

Evelyn D Davis, L.M.T., MMT

  • Massage Therapist
  • Plano, TX
National Provider Identifier
1639414675
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT123347 Issued in TX
Practice address
5501 Independence Pkwy Ste 318
Plano, TX 75023-5471
Phone
(469) 831-9652
NPI assigned
Dec 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT123347 TX Primary

Addresses

Primary practice location

5501 Independence Pkwy Ste 318
Plano, TX 75023-5471

Mailing address

5501 Independence Pkwy Ste 318
Plano, TX 75023-5471
Phone (469) 831-9652

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

LicenseStateTypeSpecialty
MT123347TXMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1639414675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 INDEPENDENCE PKWY STE 318",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750235471",
            "telephone_number": "469-831-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 INDEPENDENCE PKWY STE 318",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750235471",
            "telephone_number": "469-831-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "EVELYN",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "L.M.T., MMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TX",
            "license": "MT123347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.