Organization Active NPI

Wilma Davis - Reconnecting Families

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1821605650
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WILMA DAVIS - RECONNECTING FAMILIES
Doing business as
Wilma Davis - Reconnecting Families
Practice address
6310 Humoresque Dr
Dallas, TX 75241-2614
Phone
(121) 440-4902
Fax
(972) 685-9111
NPI assigned
Sep 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Authorized official

Name
Wilma Davis, LCSWNPI 1033583430
Title
Ceo, Founder
Phone
(214) 404-9026

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

6310 Humoresque Dr
Dallas, TX 75241-2614

Mailing address

6310 Humoresque Dr
Dallas, TX 75241-2614
Phone (121) 440-4902

Other names 1

  • Wilma Davis - Reconnecting Families Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL daviswilma@att.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201016001022 TX Part B Supplier - Clinic/Group Practice 0749600559 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1821605650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6310 HUMORESQUE DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752412614",
            "telephone_number": "121-440-4902",
            "fax_number": "972-685-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6310 HUMORESQUE DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752412614",
            "telephone_number": "121-440-4902",
            "fax_number": "972-685-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMA DAVIS - RECONNECTING FAMILIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "WILMA",
        "authorized_official_title_or_position": "CEO, FOUNDER",
        "authorized_official_telephone_number": "214-404-9026",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "daviswilma@att.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6310 Humoresque Dr",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752412614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Wilma Davis - Reconnecting Families",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.