Individual provider Active NPI

Brian Davis

  • Physical Therapist
  • Worcester, MA
National Provider Identifier
1699176230
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21218 Issued in MA
Practice address
403 Belmont St
Worcester, MA 01604-1019
Phone
(508) 425-2557
NPI assigned
Sep 15, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 21218 MA Primary

Addresses

Primary practice location

403 Belmont St
Worcester, MA 01604-1019

Mailing address

403 Belmont St
Worcester, MA 01604-1019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141027001430 MA Practitioner - Physical Therapist in Private Practice 8820219314 Reassigns benefits to 1 organization
I20181231000147 PA Practitioner - Physical Therapist in Private Practice 8820219314 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21218MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic and Sports Physical Therapy Services, Inc. Physical Therapist CurrentSince Nov 12, 2018 Accepting new patients
Joint Ventures Physical Therapy, Inc. Physical Therapist CurrentSince Feb 1, 2021 Accepting new patients
Joint Ventures Physical Therapy, Inc. CurrentSince Feb 1, 2021 Accepting new patients

Locations

10 Liberty Sq
Bsmt 1
Boston, MA 02109

648 Beacon St
Boston, MA 02215
Phone (617) 353-9345

31 Andrew Ave
Wayland, MA 01778
Phone (508) 358-3410

120 E Lancaster Ave
Ste 205
Ardmore, PA 19003
Phone (484) 297-6491

1175 Lancaster Ave
Berwyn, PA 19312
Phone (610) 651-8282

Organizations & group practices 3

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": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1699176230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041019",
            "telephone_number": "508-425-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-15",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "21218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.