Bettie Wallene Davis, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

0000000914 Issued in TN

Practice address

1420 Tusculum Blvd
Greeneville, TN 37745-4279

Phone

(423) 787-5063

Fax

(423) 787-5017

NPI assigned

Apr 20, 2007

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841417524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 WEEMS CHAPEL RD",
            "city": "MOSHEIM",
            "state": "TN",
            "postal_code": "378182841",
            "telephone_number": "423-787-5063",
            "fax_number": "423-787-5017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 TUSCULUM BLVD",
            "city": "GREENEVILLE",
            "state": "TN",
            "postal_code": "377454279",
            "telephone_number": "423-787-5063",
            "fax_number": "423-787-5017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BETTIE",
        "middle_name": "WALLENE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "0000000914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher L. Darnell, M.ED
• Jonathan Darnell
• David Dykes DDS PC
• Melanie R Davidson, MD
• Alexandria Davis
• Cathy J Davis, COTA/L
• Leila Katherine Davis, M.D.
• Michael Lynn Davis
• Milton De Brun, D.P.T.
• I. Devi Deean, MD

• Physical Therapy Assistant in Greeneville, TN
• Providers in Greeneville, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.