Active NPI
Ivy Davis
- Speech-Language Pathologist
- Austin, TX
National Provider Identifier
1841928306
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 119976
- Practice address
- Martin Middle School
1601 Haskell St
Austin, TX 78702 - Phone
- (512) 414-3243
- NPI assigned
- Aug 12, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 119976 | TX | Primary |
Addresses
Primary practice location
Martin Middle School
1601 Haskell St
Austin, TX 78702
Mailing address
302 E 30TH St Apt C
Austin, TX 78705-3890
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119976 | Medicaid | TX |
Electronic endpoints 4
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | portal.austinisd.org | Direct | |
| Other URL | https://portal.austinisd.org/ | Direct | |
| Other URL | portal.austinisd.org | Direct | |
| Other URL | https://portal.austinisd.org/ | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119976 | TX | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehabilitation Services TX LLC | Speech-Language Pathologist | Current | Accepting new patients |
Locations
7 Carnegie Plz
Cherry Hill, NJ 08003
4101 W Arkansas Ln
Arlington, TX 76016
Phone (817) 469-7671
6327 Cypresswood Dr
Spring, TX 77379
Phone (281) 374-1750
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Allen, TX
- NPI 1710582580
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660262400000",
"number": "1841928306",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 E 30TH ST APT C",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787053890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MARTIN MIDDLE SCHOOL",
"address_2": "1601 HASKELL ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78702",
"telephone_number": "512-414-3243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "IVY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-08-12",
"last_updated": "2022-08-12",
"certification_date": "2022-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "119976",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119976",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "portal.austinisd.org",
"affiliation": "N",
"endpointDescription": "School Portal",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "NA",
"address_1": "4000 S I-35 Frontage Rd",
"city": "Austin",
"state": "TX",
"country_code": "US",
"postal_code": "78704",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://portal.austinisd.org/",
"affiliation": "N",
"endpointDescription": "school portal",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "NA",
"address_1": "4000 S I-35 Frontage Rd",
"city": "Austin",
"state": "TX",
"country_code": "US",
"postal_code": "78704",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "portal.austinisd.org",
"affiliation": "N",
"endpointDescription": "School Portal",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "NA",
"address_1": "4000 S I-35 Frontage Rd",
"city": "Austin",
"state": "TX",
"country_code": "US",
"postal_code": "78704",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://portal.austinisd.org/",
"affiliation": "N",
"endpointDescription": "school portal",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "NA",
"address_1": "4000 S I-35 Frontage Rd",
"city": "Austin",
"state": "TX",
"country_code": "US",
"postal_code": "78704",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.