Active NPI
Tracy Kyle Davis, OTA/L
- Occupational Therapy Assistant
- Owens Cross Roads, AL
National Provider Identifier
1851855746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3391
- Practice address
- 213 Wilson Mann Rd
Owens Cross Roads, AL 35763-8606 - Phone
- (256) 725-3400
- NPI assigned
- Jan 25, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 3391 | AL | Primary |
Addresses
Primary practice location
213 Wilson Mann Rd
Owens Cross Roads, AL 35763-8606
Mailing address
204 Stewart St SW
Hartselle, AL 35640-2920
Phone (256) 754-4456
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3391 | AL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548374400000",
"number": "1851855746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 STEWART ST SW",
"city": "HARTSELLE",
"state": "AL",
"postal_code": "356402920",
"telephone_number": "256-754-4456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "213 WILSON MANN RD",
"city": "OWENS CROSS ROADS",
"state": "AL",
"postal_code": "357638606",
"telephone_number": "256-725-3400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "TRACY",
"middle_name": "KYLE",
"credential": "OTA/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-25",
"last_updated": "2019-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AL",
"license": "3391",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Owens Cross Roads, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.