NPIMap

Organization Active NPI

Stacey Davis, PH.D.

  • Clinical Psychologist
  • Gainesville, FL
National Provider Identifier
1851787360
Registry record updated Apr 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 7649 Issued in FL
Legal business name
STACEY DAVIS, PH.D.
Practice address
11 NW 33Rd CT
Gainesville, FL 32607-2552
Phone
(352) 870-8173
NPI assigned
Apr 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2015

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

Authorized official

Name
Dr. Stacey Davis, PH.D.
Title
Licensed Psychologist/Owner
Phone
(352) 870-8173

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY 7649 FL Primary

Addresses

Primary practice location

11 NW 33Rd CT
Gainesville, FL 32607-2552

Mailing address

11 NW 33Rd CT
Gainesville, FL 32607-2552
Phone (352) 870-8173

Other identifiers 1

IdentifierTypeStateIssuer
PY 7649OtherFLFLORIDA DEPARTMENT OF HEALTH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428624000000",
    "number": "1851787360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 NW 33RD CT",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072552",
            "telephone_number": "352-870-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 NW 33RD CT",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072552",
            "telephone_number": "352-870-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACEY DAVIS, PH.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-10",
        "last_updated": "2015-04-10",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "352-870-8173",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "PY 7649",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2015; 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.