NPI Code Detail JSON Logo

1568986446 NPI number — MICHAEL KRESS DAVIS DPT

NPI Number: 1568986446
Health Care Provider/Practitioner: MICHAEL KRESS DAVIS DPT

Information about “1568986446” NPI (MICHAEL KRESS DAVIS DPT) exists in 1568986446 in HTML format HTML  |  1568986446 in plain Text format TXT  |  1568986446 in PDF (Portable Document Format) PDF  |  1568986446 in an XML format XML  formats.

NPI Number : 1568986446 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1568986446",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DAVIS",
    "FirstName": "MICHAEL",
    "MiddleName": "KRESS",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "DPT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "200 E WILCOX DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SIERRA VISTA",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85635-2526",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "200 E WILCOX DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SIERRA VISTA",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85635-2526",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "585-764-5897",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/01/2017",
    "LastUpdateDate": "08/26/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2251X0800X",
          "TaxonomyName": "Orthopedic Physical Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2471S1302X",
          "TaxonomyName": "Sonography Radiologic Technologist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "204D00000X",
          "TaxonomyName": "Neuromusculoskeletal Medicine & OMM Physician",
          "LicenseNumber": "55565",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "133NN1002X",
          "TaxonomyName": "Nutrition Education Nutritionist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "173F00000X",
          "TaxonomyName": "Sleep Specialist (PhD)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "202D00000X",
          "TaxonomyName": "Integrative Medicine Physician",
          "LicenseNumber": "13174",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "13174",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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