Active NPI
Deborah Davis, MSPT
- Physical Therapist
- Conway, AR
National Provider Identifier
1669428314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT964
- Practice address
- 3605 College Ave
Conway, AR 72034 - Phone
- (501) 327-2235
- Fax
- (501) 327-1601
- NPI assigned
- May 25, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT964 | AR | Primary |
Addresses
Primary practice location
3605 College Ave
Conway, AR 72034
Mailing address
3605 College Ave
Conway, AR 72034
Phone (501) 327-2235
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5S399 | Other | AR | BCBS |
| P01546505 | Other | AR | PALMETTO RR |
| 184657721 | Medicaid | AR | |
| 710857801 | Other | AR | QUALCHOICE |
| A002 | Other | AR | TRICARE |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450224000000",
"number": "1669428314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3605 COLLEGE AVE",
"city": "CONWAY",
"state": "AR",
"postal_code": "72034",
"telephone_number": "501-327-2235",
"fax_number": "501-327-1601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3605 COLLEGE AVE",
"city": "CONWAY",
"state": "AR",
"postal_code": "72034",
"telephone_number": "501-327-2235",
"fax_number": "501-327-1601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DEBORAH",
"name_prefix": "Ms.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-25",
"last_updated": "2015-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "PT964",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5S399",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO RR",
"identifier": "P01546505",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184657721",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUALCHOICE",
"identifier": "710857801",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "A002",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.