Active NPI
Dominique Nicolle Davis, ITDS
- Developmental Therapist
- Tampa, FL
National Provider Identifier
1912754235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 13014 N Dale Mabry Hwy # 659
Tampa, FL 33618-2808 - Phone
- (813) 215-6275
- NPI assigned
- May 3, 2024
- 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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
13014 N Dale Mabry Hwy # 659
Tampa, FL 33618-2808
Mailing address
1568 W Windy Willow Dr
St Augustine, FL 32092-5098
Phone (904) 217-9732
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763337600000",
"number": "1912754235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1568 W WINDY WILLOW DR",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320925098",
"telephone_number": "904-217-9732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13014 N DALE MABRY HWY # 659",
"city": "TAMPA",
"state": "FL",
"postal_code": "336182808",
"telephone_number": "813-215-6275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DOMINIQUE",
"middle_name": "NICOLLE",
"credential": "ITDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-03",
"last_updated": "2025-11-17",
"certification_date": "2025-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.