Active NPI
Jared Davis, DPT
- Physical Therapist
- Minot, ND
National Provider Identifier
1659925972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT013958
- Practice address
- 10 Missile Ave
Minot, ND 58705-5003 - Phone
- (701) 723-5095
- NPI assigned
- Jul 25, 2019
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT013958 | GA | Primary |
Addresses
Primary practice location
10 Missile Ave
Minot, ND 58705-5003
Mailing address
10 Missile Ave
Minot, ND 58705-5003
Phone (701) 723-5095
Other practice location 1
541 Historic Hiwy 441
Demorest, GA 30535
Phone (706) 754-2161
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 |
|---|---|---|---|
| PT013958 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687305600000",
"number": "1659925972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 MISSILE AVE",
"city": "MINOT",
"state": "ND",
"postal_code": "587055003",
"telephone_number": "701-723-5095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 MISSILE AVE",
"city": "MINOT",
"state": "ND",
"postal_code": "587055003",
"telephone_number": "701-723-5095"
}
],
"practiceLocations": [
{
"address_1": "541 Historic Hiwy 441",
"address_purpose": "LOCATION",
"city": "Demorest",
"state": "GA",
"postal_code": "30535",
"country_code": "US",
"telephone_number": "706-754-2161",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "JARED",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-25",
"last_updated": "2023-06-21",
"certification_date": "2023-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT013958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minot, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.