Individual provider Active NPI

Erin-Elizabeth Maccarry Davis, DC

  • Chiropractor
  • South Lake Tahoe, CA
National Provider Identifier
1922359520
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
32423 Issued in CA
Practice address
591 Tahoe Keys Blvd Ste D3
South Lake Tahoe, CA 96150-3359
Phone
(530) 577-4757
Fax
(530) 600-2187
NPI assigned
Sep 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Chiropractor 111NP0017X 32423 CA
Radiology Chiropractor 111NR0200X 32423 CA
Chiropractor 111N00000X 32423 CA Primary

Addresses

Primary practice location

591 Tahoe Keys Blvd Ste D3
South Lake Tahoe, CA 96150-3359

Mailing address

15520 Rockfield Blvd Ste A200
Irvine, CA 92618-6705
Phone (949) 598-9999

Other names 1

  • Erin E Maccarry Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140214001078 CA Practitioner - Chiropractic 5991934937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

591 Tahoe Keys Blvd
Suite D3
South Lake Tahoe, CA 96150-3359
Phone (530) 577-4757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32423CAMDPediatric Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Maccarry Davis Chiropractic Corp Chiropractor CurrentSince Dec 2, 2014 Accepting new patients

Locations

15520 Rockfield Blvd
Ste A200
Irvine, CA 92618

Organizations & group practices 1

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": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1922359520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15520 ROCKFIELD BLVD STE A200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926186705",
            "telephone_number": "949-598-9999",
            "fax_number": "949-598-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "591 TAHOE KEYS BLVD STE D3",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961503359",
            "telephone_number": "530-577-4757",
            "fax_number": "530-600-2187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ERIN-ELIZABETH",
        "middle_name": "MACCARRY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "CA",
            "license": "32423",
            "primary": false
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "CA",
            "license": "32423",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "32423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "MACCARRY",
            "middle_name": "E",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; 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.