Phillip Alan Davis, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.027614 Issued in IL

Practice address

1021 N Mulford Rd
Rockford, IL 61107-3874

Phone

(888) 928-0212

NPI assigned

Mar 17, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CMC Healthcare LLCGroup PAC ID 4688039209, 133 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CMC Healthcare LLC

  • Nurse Practitioner
  • Evanston, IL
  • NPI 1295432334
  Medicare reassignment Care Compare group NPD
• Edgewood Clinical Services, P.C.

  • Psychologist
  • Naperville, IL
  • NPI 1295914646

  Clinical

  Medicare reassignment NPD
• Sondermind PC

  • Clinical Social Worker
  • San Jose, CA
  • NPI 1003646977

  IL

  Medicare reassignment NPD
• American Lutheran Church Mendota

  • Nursing Facility/Intermediate Care Facility
  • Mendota, IL
  • NPI 1801850177
  NPD
• Family Counseling Services of Northern Illinois

  • Clinical Social Worker
  • Rockford, IL
  • NPI 1639241748
  NPD (past)
• Psychology Specialists LTD

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758931200000",
    "number": "1891370201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073874",
            "telephone_number": "888-928-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073874",
            "telephone_number": "888-928-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "PHILLIP",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-17",
        "last_updated": "2025-09-27",
        "certification_date": "2025-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.027614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "rosecrance.org",
            "affiliation": "N",
            "address_1": "1021 N Mulford Rd",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "611073874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrew Joseph Davis, PHARM.D.
• Audrey Anna Davis, RSA
• Charles M Davis, M.D.
• Dawn Davis
• Lisa A Davis, M.D.
• Raymond A. Davis, MD
• Rosey Cassioppi Davis
• Wayne Byron Davis, D.C.
• Altaf Dawood, M.D.
• Michelle Renee Day, RPH

• Clinical Social Worker in Rockford, IL
• Providers in Rockford, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.