Individual provider Active NPI

Kami Davis

  • Clinical Social Worker
  • Plainville, CT
National Provider Identifier
1902334402
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
74 East St
Plainville, CT 06062-2367
Phone
(908) 338-1027
NPI assigned
May 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

74 East St
Plainville, CT 06062-2367

Mailing address

74 East St
Plainville, CT 06062-2367
Phone (908) 338-1027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20200131001283 CT Practitioner - Clinical Social Worker 1759717267 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revive Wellness LLCGroup PAC ID 2668851064, 4 clinicians

Practice addresses (Care Compare)

1068 W Main St
1St FL.
Waterbury, CT 06708-2676
Phone (203) 518-4526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wheeler Clinic Inc CurrentSince Dec 10, 2019 Accepting new patients
State of Connecticut CurrentSince Mar 4, 2024 Accepting new patients
Wheeler Clinic Inc CurrentSince Dec 10, 2019 Accepting new patients
State of Connecticut CurrentSince Mar 4, 2024 Accepting new patients

Locations

450 Columbus Blvd
Ste 1001
Hartford, CT 06103

500 Vine St
Hartford, CT 06112
Phone (860) 293-6400

91 Northwest Dr
Plainville, CT 06062
Phone (860) 793-3871

Interoperability endpoints

  • Direct secure messaging: kami.davis.p1@direct.wheelerclinic.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1495843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1902334402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 EAST ST",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060622367",
            "telephone_number": "908-338-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 EAST ST",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060622367",
            "telephone_number": "908-338-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KAMI",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainville, CT

Sources for this page

Verify at the official NPI Registry.