David Davis, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1263136 Issued in TX

Practice address

707 Hollybrook Dr Ste 500
Longview, TX 75605-2409

Phone

(903) 291-6113

Fax

(903) 234-9126

NPI assigned

Aug 25, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Associated Clinicians of East TexasGroup PAC ID 4789957440, 106 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.davis.1@23550.direct.athenahealth.com

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.

• Associated Clinicians of East Texas

  • Internal Medicine Physician
  • Longview, TX
  • NPI 1932640349

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Associated Clinicians of East Texas

  • Community/Retail Pharmacy
  • Longview, TX
  • NPI 1447451406
  NPD (past)
• Pain Managment Joint Venture LLP

  • Physical Therapist
  • Longview, TX
  • NPI 1871540971
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1669849683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610393",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752610393",
            "telephone_number": "903-757-6042",
            "fax_number": "903-237-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 HOLLYBROOK DR STE 500",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052409",
            "telephone_number": "903-291-6113",
            "fax_number": "903-234-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DAVID",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-25",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1263136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "353658303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tatiana Dejanie Darthard
• Michelle Davenport, OTR
• David Lane Brown, MD
• David Vaca Jr DDS PA
• Davis Medical Professionals
• Donna Davis, MD
• Hailey Ann Davis
• Lamont A Davis, FNP
• Mary Ann Davis
• Robert Francis Davis III, DDS

• Physical Therapist in Longview, TX
• Providers in Longview, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.