Eric Samuel Davis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7843 Issued in OR

Practice address

608 Lancaster Dr SE
Salem, OR 97317-5643

Phone

(503) 877-1995

NPI assigned

May 10, 2007

Last updated

Sep 9, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mr. Eric Samuel Davis Other name

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Confederated Tribes of SiletzGroup PAC ID 6204729288, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eric.davis.p100@direct.wvp.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Confederated Tribes of Siletz

  dba Siletz Community Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Siletz, OR
  • NPI 1316040249
  Medicare reassignment Care Compare group NPD
• JD Health and Wellness Center, Inc

  • Naturopath
  • Salem, OR
  • NPI 1689918161

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD
• JD Health and Wellness Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Salem, OR
  • NPI 1013363910
  Authorized official Same address or phone
• Confederated Tribes of Siletz

  dba Siletz Community Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Lincoln City, OR
  • NPI 1306667845
  NPD

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1790990224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 LANCASTER DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973175643",
            "telephone_number": "503-877-1995",
            "fax_number": "503-877-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 LANCASTER DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973175643",
            "telephone_number": "503-877-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ERIC",
        "middle_name": "SAMUEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "7843",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "14-04-26",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A4913",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIC",
            "last_name": "DAVIS",
            "middle_name": "SAMUEL",
            "prefix": "MR.",
            "credential": "MSW, LCSW, CADCIII,",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Billie Nadine Davis, MS SLP
• Cindy Davis, NP, NEONATAL
• Debby Jean Davis, LPC
• Desiree Davis, MA, CGACI
• Diane B Davis, LPCA
• Eryn Davis
• Gabrielle Elizabeth Davis
• Heidi Davis, LMT
• Katrina Ellen Davis, CPNP
• Lissa Davis

• Clinical Social Worker in Salem, OR
• Providers in Salem, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.