Active NPI
Daniel Garrett Davis
- Student in an Organized Health Care Education/Training Program
- Lubbock, TX
National Provider Identifier
1750955720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 3601 4TH St
Lubbock, TX 79430-0002 - Phone
- (806) 743-3150
- NPI assigned
- May 14, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
3601 4TH St
Lubbock, TX 79430-0002
Mailing address
223 Indiana Ave Apt 4207
Lubbock, TX 79415-5360
Phone (512) 653-9708
Other practice location 1
602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 775-9700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210701003850 | TX | Order and Referring Only - Gastroenterology | 4284035890 |
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": "1620950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620950400000",
"number": "1750955720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 INDIANA AVE APT 4207",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794155360",
"telephone_number": "512-653-9708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3601 4TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794300002",
"telephone_number": "806-743-3150"
}
],
"practiceLocations": [
{
"address_1": "602 Indiana Ave",
"address_purpose": "LOCATION",
"city": "Lubbock",
"state": "TX",
"postal_code": "794153364",
"country_code": "US",
"telephone_number": "806-775-9700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "DANIEL",
"middle_name": "GARRETT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-14",
"last_updated": "2021-05-14",
"certification_date": "2021-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.