Individual provider Active NPI

Cyril Davis

  • Psychiatric/Mental Health Nurse Practitioner
  • West Bloomfield, MI
National Provider Identifier
1922863810
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704352236 Issued in MI
Practice address
2300 Haggerty Rd Ste 2160
West Bloomfield, MI 48323-2192
Phone
(248) 859-2457
Fax
(248) 859-2473
NPI assigned
Feb 19, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704352236 MI Primary

Addresses

Primary practice location

2300 Haggerty Rd Ste 2160
West Bloomfield, MI 48323-2192

Mailing address

2300 Haggerty Rd Ste 2160
West Bloomfield, MI 48323-2192
Phone (248) 859-2457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260317001693 MI Practitioner - Nurse Practitioner 1951884014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2300 Haggaerty Rd
West Bloomfield, MI 48323-2184

2300 Haggerty Rd
Suite 2160
West Bloomfield, MI 48323-2192

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704352236MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
C Blake Resilience LLC Psychiatric/Mental Health CurrentSince Jan 18, 2026 Accepting new patients

Locations

2300 Haggerty Rd
Ste 2160
West Bloomfield, MI 48323
Phone (248) 539-0899

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": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1922863810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HAGGERTY RD STE 2160",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232192",
            "telephone_number": "248-859-2457",
            "fax_number": "248-859-2473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HAGGERTY RD STE 2160",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232192",
            "telephone_number": "248-859-2457",
            "fax_number": "248-859-2473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CYRIL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-19",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704352236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.