Freddie T. Davis, COTA/L

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

3109 Issued in SC

Practice address

175 Burdette St
Spartanburg, SC 29307-1003

Phone

(864) 596-8491

Fax

(864) 596-8495

NPI assigned

Dec 11, 2015

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1449792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1992170203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293040970",
            "telephone_number": "864-596-8491",
            "fax_number": "864-596-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 BURDETTE ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071003",
            "telephone_number": "864-596-8491",
            "fax_number": "864-596-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "FREDDIE",
        "middle_name": "T.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": "3109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Duane Davis, DO
• Brandon Scott Davis, M.D.
• Cortney A Davis, ARNP
• Dean Eldon Davis, M.D.
• Elizabeth R Davis, MD
• Jason J Davis, D.M.D.
• Jocelyn Leclare Davis, RN
• Justin Brian Davis
• Keith C. Davis, D.M.D.
• Leann C. Davis

• Student in an Organized Health Care Education/Training Program in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Student in an Organized Health Care Education/Training Program in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.