Robert O Davis

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

License

21-CRM-569 Issued in OR

Practice address

46314 Timine Way
Pendleton, OR 97801

Phone

(541) 966-9830

NPI assigned

Jul 7, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Robert Owen Davis Other name

Electronic endpoints 1

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": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1922679240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "97801",
            "telephone_number": "541-966-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46314 TIMINE WAY",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "97801",
            "telephone_number": "541-966-9830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1184 McGee Ct NE",
            "address_purpose": "LOCATION",
            "city": "Keizer",
            "state": "OR",
            "postal_code": "973039443",
            "country_code": "US",
            "telephone_number": "503-304-4358",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROBERT",
        "middle_name": "O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-07",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-17-405",
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "OR",
            "license": "21-CRM-569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHACBO",
            "identifier": "T-17-405",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "odavis@oregonrecovery.com",
            "affiliation": "N",
            "address_1": "465 Commercial St NE # 150",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973013414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "DAVIS",
            "middle_name": "OWEN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anna Curry
• Cynthia S Holmes MD PC
• Khaila Jane Dahlberg
• Carol M Danford, CADC-I
• Mathew Walker Davis, CRM
• Saskia Davis
• Jessica Lynne Davison, CSWA
• Angela R Dearing, PHARMD
• Francis Demers, CRNA
• Julie Denny

• Prevention Professional in Pendleton, OR
• Providers in Pendleton, OR by specialty
• Prevention Professional in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.