Audrey K Davis, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202002584 Issued in VA

Practice address

1009 Old Country Club Rd NW
Roanoke, VA 24017-2927

Phone

(540) 767-6800

NPI assigned

Dec 29, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Functional Pathways Preferred of Tennessee LLCGroup PAC ID 2860649654, 194 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Functional Pathways Preferred of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1841561446

  Speech-Language Pathologist, VA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1293580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1912201237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 TIMBERLINE DR",
            "city": "BLUE RIDGE",
            "state": "VA",
            "postal_code": "240641601",
            "telephone_number": "540-525-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 OLD COUNTRY CLUB RD NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240172927",
            "telephone_number": "540-767-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "83 Timberline Dr",
            "address_purpose": "LOCATION",
            "city": "Blue Ridge",
            "state": "VA",
            "postal_code": "240641601",
            "country_code": "US",
            "telephone_number": "540-525-3260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AUDREY",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-29",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202002584",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "01105990",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia H Davidson, LCSW
• Tamara Davidson, PHARMD
• Thomas John Davidson IV, DPM
• Davis and McDaniel Veterans Care Center
• Alexander Davis, L. AC.
• Beverly A Davis, PA-C
• Brittney Allison Davis, PHARMD
• Emily Davis, OTR
• Felicia Nicole Davis, LCSW
• Grantrina Antwunet Davis

• Speech-Language Pathologist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.