Individual provider Active NPI

Claudia Davisson, M.A. CCC-SLP/L

  • Speech-Language Pathologist
  • Saint Joseph, MI
National Provider Identifier
1972163491
Registry record updated Sep 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101001065 Issued in MI
Practice address
1030 Miners Rd Ste C
Saint Joseph, MI 49085-9709
Phone
(269) 235-9083
Fax
(269) 359-3735
NPI assigned
Jun 17, 2019
Last updated
Sep 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7101001065 MI Primary

Addresses

Primary practice location

1030 Miners Rd Ste C
Saint Joseph, MI 49085-9709

Mailing address

1030 Miners Rd Ste C
Saint Joseph, MI 49085-9709
Phone (269) 235-9083

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210407002858 MI Practitioner - Qualified Speech Language Pathologist 5294142345 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693699200000",
    "number": "1972163491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 MINERS RD STE C",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859709",
            "telephone_number": "269-235-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 MINERS RD STE C",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859709",
            "telephone_number": "269-235-9083",
            "fax_number": "269-359-3735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISSON",
        "first_name": "CLAUDIA",
        "name_prefix": "Ms.",
        "credential": "M.A. CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2023-09-03",
        "certification_date": "2023-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101001065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.