Andrew Blake Davis, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA002490 Issued in WV

Practice address

298 Tricorn Rd
Danville, WV 25053-7148

Phone

(304) 369-1385

NPI assigned

Sep 8, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Boone Memorial Homecare, LLC

  • Home Health Agency
  • Danville, WV
  • NPI 1184848970
  NPD

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1689451148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 3RD ST",
            "city": "MADISON",
            "state": "WV",
            "postal_code": "251301435",
            "telephone_number": "304-654-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 TRICORN RD",
            "city": "DANVILLE",
            "state": "WV",
            "postal_code": "250537148",
            "telephone_number": "304-369-1385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ANDREW",
        "middle_name": "BLAKE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "PTA002490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Paige Cummings
• Alicia Cyrus
• Valerie Dalton
• Danville Pharmacy LLC
• Allison Darnell
• Hannah Davis
• Johnna Dean, LPN
• Misty Demuth
• Rebecca Depta
• Alana Dillon

• Physical Therapy Assistant in Danville, WV
• Providers in Danville, WV by specialty
• Physical Therapy Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.

Verify at the official NPI Registry.