Individual provider Active NPI

Phyllis C. Davis, M.ED., M.S. ED.

  • School Psychologist
  • Cincinnati, OH
National Provider Identifier
1851630594
Registry record updated Jan 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
KY1014651 Issued in OH
Practice address
4131 Matson Ave
Cincinnati, OH 45236-2509
Phone
(513) 936-5923
Fax
(513) 891-2930
NPI assigned
Jan 31, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X KY1014651 OH Primary

Addresses

Primary practice location

4131 Matson Ave
Cincinnati, OH 45236-2509

Mailing address

11484 Oxfordshire LN
Cincinnati, OH 45240-2135
Phone (513) 742-2423

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)
Not enrolled
Credentials
Master of Education, Master of Science

State licenses

LicenseStateTypeSpecialty
KY1014651OHMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1851630594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11484 OXFORDSHIRE LN",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452402135",
            "telephone_number": "513-742-2423",
            "fax_number": "513-891-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 MATSON AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452362509",
            "telephone_number": "513-936-5923",
            "fax_number": "513-891-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "PHYLLIS",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "M.ED., M.S. ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-31",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OH",
            "license": "KY1014651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; 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.