Active NPI
Bianica Chantel Davis, OTR/L
- Occupational Therapist
- Jacksonville, FL
National Provider Identifier
1659527703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 12442
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 12442 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New 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
- 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.
-
- General Acute Care Hospital
- West Columbia, SC
- NPI 1356366314
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.