Michael Wayne Davis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904005678 Issued in VA

Practice address

10299 Woodman Rd
Glen Allen, VA 23060-4419

Phone

(804) 727-8517

Fax

(804) 727-8580

NPI assigned

Nov 14, 2007

Last updated

Jul 25, 2008By 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 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in VA

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, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henrico Area Mental Heatlh and Developmental ServicesGroup PAC ID 8022004811, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Henrico Area Mental Heatlh and Developmental Services

  dba Henrico Area Mental Health & Developmental Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Glen Allen, VA
  • NPI 1023119773
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216944000000",
    "number": "1821279266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10299 WOODMAN RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230604419",
            "telephone_number": "804-727-8517",
            "fax_number": "804-727-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10299 WOODMAN RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230604419",
            "telephone_number": "804-727-8517",
            "fax_number": "804-727-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-14",
        "last_updated": "2008-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904005678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA PREMIER",
            "identifier": "4945131",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "324461",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4945131",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "342707",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA",
            "identifier": "O803365M",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darchelle Braxton DMD PC (Toothbeary Pediatric Dentistry)
• Megan C Davidson, LPC
• Mary Davies
• Allison Davis, OTR/L
• Lashawnda Davis
• Misty Davis, M S
• Tanya L Davis
• Patricia Daylor
• Thomas D Dayspring, MD, FACP
• Lerese A Deberry, LPC

• Clinical Social Worker in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.