Active NPI
Tyler Davis
- Psychologist
- Glendale, AZ
National Provider Identifier
1881013266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4485
- Practice address
- 8607 N 59TH Ave
#C-6
Glendale, AZ 85302-5433 - Phone
- (602) 753-8040
- NPI assigned
- Apr 14, 2014
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4485 | AZ | Primary |
Addresses
Primary practice location
8607 N 59TH Ave
#C-6
Glendale, AZ 85302-5433
Mailing address
8607 N 59TH Ave
#C-6
Glendale, AZ 85302-5433
Phone (602) 753-8040
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397433600000",
"number": "1881013266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8607 N 59TH AVE",
"address_2": "#C-6",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853025433",
"telephone_number": "602-753-8040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8607 N 59TH AVE",
"address_2": "#C-6",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853025433",
"telephone_number": "602-753-8040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "TYLER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-14",
"last_updated": "2014-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "4485",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.