Robert J Davis, SAC-IT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

17487-130 Issued in WI

Practice address

2000 N Oxford Ave Ste 2
Eau Claire, WI 54703-5187

Phone

(715) 834-1078

NPI assigned

Jan 11, 2018

Last updated

Jan 11, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Metro Treatment of Wi, LP

  dba Eau Claire Metro Treatment Center

  • Methadone Clinic
  • Eau Claire, WI
  • NPI 1023223831
  NPD (past)

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1821506981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 N DEWEY ST APT 2",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547033640",
            "telephone_number": "715-450-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N OXFORD AVE STE 2",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547035187",
            "telephone_number": "715-834-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "SAC-IT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "17487-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Davies, MD
• Dedra Desiree Davis-Wallace, DDS
• Ashley Davis, APNP
• Georgia P Davis, PT
• Holly Davis, LPC-IT
• Elizabeth Davison, MS
• Michael Dawson, MD
• Cody Dayton
• Brett De Kooker
• Alicia Dean, MSW, LCSW

• Addiction (Substance Use Disorder) Counselor in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.