Demekisa Sidamo Davis, D.O.M.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AP1210 Issued in FL

Practice address

5301 Gulfport Blvd
Gulfport, FL 33707

Phone

(727) 642-6470

Fax

(727) 866-8575

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1902987902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 GULFPORT BLVD.",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "33707",
            "telephone_number": "727-642-6470",
            "fax_number": "727-866-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 GULFPORT BLVD",
            "city": "GULFPORT",
            "state": "FL",
            "postal_code": "33707",
            "telephone_number": "727-642-6470",
            "fax_number": "727-866-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DEMEKISA",
        "middle_name": "SIDAMO",
        "name_prefix": "Dr.",
        "credential": "D.O.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP1210",
            "primary": true
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "ID",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mathew P Cherian
• Nicholas Robert Chiappone, PMHNP-BC
• Harriet Cohen
• Jacqueline Sue Colunga, LCSW
• Maria Culp
• Ife Davis, SPECIALIST
• Douglas Aaron Day, DC
• Brittany N Dillard, OT/L
• Dr. Elizabeth a. Douglas D.C.
• Dr. Katie Schubert, LLC

• Acupuncturist in Gulfport, FL
• Providers in Gulfport, FL by specialty
• Acupuncturist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.