Active NPI
Samon Davis, OTR/L
- Occupational Therapist
- South Hadley, MA
National Provider Identifier
1891338174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 13124
- Practice address
- 30 Old Lyman Rd
South Hadley, MA 01075-2630 - Phone
- (413) 533-7140
- Fax
- (413) 538-9757
- NPI assigned
- Oct 19, 2019
- Sex
- Female
- 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 Therapist | 225X00000X | 13124 | MA | Primary |
Addresses
Primary practice location
30 Old Lyman Rd
South Hadley, MA 01075-2630
Mailing address
30 Old Lyman Rd
South Hadley, MA 01075-2630
Phone (413) 533-7140
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 |
|---|---|---|---|
| 13124 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571788800000",
"number": "1891338174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 OLD LYMAN RD",
"city": "SOUTH HADLEY",
"state": "MA",
"postal_code": "010752630",
"telephone_number": "413-533-7140",
"fax_number": "413-538-9757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 OLD LYMAN RD",
"city": "SOUTH HADLEY",
"state": "MA",
"postal_code": "010752630",
"telephone_number": "413-533-7140",
"fax_number": "413-538-9757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "SAMON",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-19",
"last_updated": "2019-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "13124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Hadley, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.