Individual provider Active NPI

Brooke E Davis, CDCA

  • Case Manager/Care Coordinator
  • Zanesville, OH
National Provider Identifier
1669040390
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
2811 Maysville Pike
Zanesville, OH 43701-9772
Phone
(740) 487-1474
NPI assigned
Jun 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA183010 OH
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

2811 Maysville Pike
Zanesville, OH 43701-9772

Mailing address

9 Chesapeake PLZ
Chesapeake, OH 45619-1003
Phone (740) 624-4524

Other identifiers 1

IdentifierTypeStateIssuer
0462766MedicaidOH

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
CDCA183010OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Group Home, LLC Past Accepting new patients
Phoenix Group Home, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/pathihc/r4/

Organizations & group practices 2

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": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1669040390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CHESAPEAKE PLZ",
            "city": "CHESAPEAKE",
            "state": "OH",
            "postal_code": "456191003",
            "telephone_number": "740-624-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 MAYSVILLE PIKE",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437019772",
            "telephone_number": "740-487-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BROOKE",
        "middle_name": "E",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA183010",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0462766",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.