Individual provider Active NPI

Sheera Tzippora Davis

  • Clinical Social Worker
  • Hollywood, FL
National Provider Identifier
1780198333
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14976 Issued in FL
Practice address
901 S 62ND Ave
Hollywood, FL 33023-1848
Phone
(561) 790-1191
NPI assigned
Nov 17, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW14976 FL Primary

Addresses

Primary practice location

901 S 62ND Ave
Hollywood, FL 33023-1848

Mailing address

3900 N Hills Dr Apt 414
Hollywood, FL 33021-2540
Phone (347) 848-4210

Other identifiers 1

IdentifierTypeStateIssuer
692353MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191024003361 FL Practitioner - Clinical Social Worker 7214269174 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SD Counseling Services Clinical Current Accepting new patients
Cotler Children and Family Services, LLC CurrentSince Oct 1, 2019 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients

Locations

901 S 62nd Ave
Hollywood, FL 33023
Phone (954) 893-0109

9835 Lake Worth Rd
Ste 16179
Lake Worth, FL 33467

8461 Lake Worth Rd
Ste 250
Lake Worth, FL 33467

Interoperability endpoints

  • Direct secure messaging: sheeradavis@tdh.allscriptsdirect.net

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": "1510876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1780198333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 N HILLS DR APT 414",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330212540",
            "telephone_number": "347-848-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S 62ND AVE",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330231848",
            "telephone_number": "561-790-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHEERA",
        "middle_name": "TZIPPORA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-17",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "692353",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.