Active NPI
Brian Wayne Davis, COTA/L
- Occupational Therapy Assistant
- Smyrna, DE
National Provider Identifier
1881178796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- U2-0000204
- Practice address
- 20 W Frazier St
Smyrna, DE 19977-1416 - Phone
- (302) 653-2758
- NPI assigned
- Sep 18, 2018
- Last updated
- Sep 18, 2018
- Sex
- Male
- Sole proprietor
- No
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 | U2-0000204 | DE | Primary |
Addresses
Primary practice location
20 W Frazier St
Smyrna, DE 19977-1416
Mailing address
215 Pitch Kettle CT
Magnolia, DE 19962-1592
Phone (302) 236-7310
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 |
|---|---|---|---|
| U2-0000204 | DE | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537228800000",
"number": "1881178796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 PITCH KETTLE CT",
"city": "MAGNOLIA",
"state": "DE",
"postal_code": "199621592",
"telephone_number": "302-236-7310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 W FRAZIER ST",
"city": "SMYRNA",
"state": "DE",
"postal_code": "199771416",
"telephone_number": "302-653-2758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "BRIAN",
"middle_name": "WAYNE",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-18",
"last_updated": "2018-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "DE",
"license": "U2-0000204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smyrna, DE
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- Faithwin Nkechinyere Daniel-Nwosuocha, FNP
- Alexys R. Daut, M.D.
- Robert Anthony Dawson, RN , BSN
- Deakyne, Dental Associates, P.a.
- David R. Deakyne, Jr., D.M.D.
- Kenneth M Decker II, DC
- Gregg Edward Dedomenico, PT, DPT, MS, ATC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.