Individual provider Active NPI

Bianica Chantel Davis, OTR/L

  • Occupational Therapist
  • Jacksonville, FL
National Provider Identifier
1659527703
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
12442 Issued in FL
Practice address
1141 Kendall Town Blvd
Unit E 6203
Jacksonville, FL 32225-7242
Phone
(309) 254-8724
NPI assigned
Aug 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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 12442 FL Primary

Addresses

Primary practice location

1141 Kendall Town Blvd
Unit E 6203
Jacksonville, FL 32225-7242

Mailing address

1141 Kendall Town Blvd
Unit E 6203
Jacksonville, FL 32225-7242
Phone (309) 254-8724

Other practice location 1

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2816

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
12442FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington County Health Services District Inc Current Accepting new patients

Locations

2720 Sunset Blvd
West Columbia, SC 29169
Phone (803) 791-2480

Interoperability endpoints

  • Direct secure messaging: bdavis146110@direct.lexmed.com

Organizations & group practices 1

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": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1659527703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 KENDALL TOWN BLVD",
            "address_2": "UNIT E 6203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322257242",
            "telephone_number": "309-254-8724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 KENDALL TOWN BLVD",
            "address_2": "UNIT E 6203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322257242",
            "telephone_number": "309-254-8724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2720 Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "291694810",
            "country_code": "US",
            "telephone_number": "803-791-2816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BIANICA",
        "middle_name": "CHANTEL",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-08",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "12442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; 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.