Shelly Davies, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306603980 Issued in VA

Practice address

8111 Tis Well Dr
Alexandria, VA 22306-3211

Phone

(703) 348-7571

Fax

(703) 780-6438

NPI assigned

Apr 25, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493078400000",
    "number": "1821523093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 N PICKETT ST",
            "address_2": "APT 203",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041064",
            "telephone_number": "904-624-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 TIS WELL DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223063211",
            "telephone_number": "703-348-7571",
            "fax_number": "703-780-6438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "SHELLY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2017-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306603980",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A4539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David M. Goldberg, O.D., P.C.
• David W Alway MD
• Mary-Katherine Davidson-Taylor, M.S. OTR/L
• Gary M Davidson, MD
• Melinda Woodall Davidson
• Marcelo A. Davila
• Mariela D. Davila, LCSW
• Jashawn Anthonette Davis-Johnson
• Alisia Davis, LCSW
• Annie Elizabeth Davis, PA-C

• Physical Therapy Assistant in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2017; 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.