Individual provider Active NPI

Anna F Davis, PHD

  • Cognitive & Behavioral Psychologist
  • Bartlett, TN
National Provider Identifier
1780791897
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
01224 Issued in TN
Practice address
3173 Kirby Whitten Rd
#104
Bartlett, TN 38134-2881
Phone
(901) 685-3697
Fax
(901) 302-9240
NPI assigned
Aug 24, 2006
Last updated
Nov 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 01224 TN Primary
Clinical Psychologist 103TC0700X 1224 TN

Addresses

Primary practice location

3173 Kirby Whitten Rd
#104
Bartlett, TN 38134-2881

Mailing address

3173 Kirby Whitten Rd Ste 104
Bartlett, TN 38134-2881
Phone (901) 384-8040

Other identifiers 1

IdentifierTypeStateIssuer
Q017419MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20040414000457 TN Practitioner - Clinical Psychologist 4880688522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatry Group PLLCGroup PAC ID 1456313006, 7 clinicians

Practice addresses (Care Compare)

3173 Kirby Whitten Rd
Suite 104
Bartlett, TN 38134-2881
Phone (901) 384-8040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Memphis Center for Women and Families Clinical CurrentSince Aug 6, 2017 Accepting new patients
Psychiatry Group PLLC CurrentSince Nov 1, 2018 Accepting new patients
Adrain B. Blotner MD PC Past Accepting new patients

Locations

3173 Kirby Whitten Rd
Ste 104
Bartlett, TN 38134
Phone (901) 384-3606

5154 Stage Rd
Ste 102
Memphis, TN 38134
Phone (901) 372-9133

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1780791897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3173 KIRBY WHITTEN RD STE 104",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342881",
            "telephone_number": "901-384-8040",
            "fax_number": "901-309-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3173 KIRBY WHITTEN RD",
            "address_2": "#104",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381342881",
            "telephone_number": "901-685-3697",
            "fax_number": "901-302-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ANNA",
        "middle_name": "F",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "TN",
            "license": "01224",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "1224",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q017419",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

Verify at the official NPI Registry.