Judith Davis, PSY.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2212057 Issued in WI

Practice address

716 Roby Rd
Stoughton, WI 53589

Phone

(608) 206-5377

NPI assigned

Aug 1, 2007

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534896000000",
    "number": "1720278005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 ROBY RD",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "535891338",
            "telephone_number": "608-206-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 ROBY RD",
            "city": "STOUGHTON",
            "state": "WI",
            "postal_code": "53589",
            "telephone_number": "608-206-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2018-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WI",
            "license": "2212057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39128800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kara Elise Conley, PT, DPT
• Nicholas Cox, PHARMD
• Christina M Czappa
• D.R. Medical Rides LLC
• Jean A Daute, MS LPC CSAC ICS MAC
• Dean Health Systems, Inc.
• Dean Retail Services, Inc.
• Jane Grinyer Dean, M.S. CCC-SLP
• Tina Marie Degroot, APNP
• Emily Ann Denure

• Clinical Neuropsychologist in Stoughton, WI
• Providers in Stoughton, WI by specialty
• Clinical Neuropsychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.