Andrew E Davis, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A5591 Issued in NC

Practice address

2453 Gum Branch Rd Ste 600
Jacksonville, NC 28540-4008

Phone

(910) 353-9800

Fax

(910) 455-2083

NPI assigned

Jun 19, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Jacksonville Physical Therapy Center, Inc.

  • Physical Therapy Clinic/Center
  • Jacksonville, NC
  • NPI 1558546184
  NPD

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1922842640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2453 GUM BRANCH RD STE 600",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404008",
            "telephone_number": "910-353-9800",
            "fax_number": "910-455-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2453 GUM BRANCH RD STE 600",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404008",
            "telephone_number": "910-353-9800",
            "fax_number": "910-455-2083"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2453 Gum Branch Rd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285404008",
            "country_code": "US",
            "telephone_number": "910-353-9800",
            "fax_number": "910-455-2083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ANDREW",
        "middle_name": "E",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A5591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiley Donita Daughtry, N/A
• David Johnson DDS PA
• David M. Stella, OD, PA
• Marieanne Davila, MS, CCC-SLP
• Amanda Davis
• Beth Ann Davis, MPA, RD, LDN
• Cenaya Davis
• Eddie Bee Davis Jr.
• Gerald Macon Davis, LMFT
• Gillian Davis, LCSWA

• Physical Therapy Assistant in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; 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.