DERRICK DAVIS (NPI# 1801203609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801203609 |
| Entity Type | Individual |
| Full Name | DERRICK DAVIS |
| Practice Address |
1063 Duckwood Dr Apt 205 Eagan MN 55123-1206 |
| Practice Telephone | 6125186455 |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2014-07-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
2527 | MN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245612621 | Derrick Davis Sr. | Nurse Practitioner | 18286 Boxelder Dr, Brownstown, MI 48174-9261 | 2015-06-23 |
| 1265620611 | Derrick Lavel Davis Sr. | Counselor | 4601 Park Rd Ste 400, Charlotte, NC 28209-2284 | 2007-10-11 |
| 1285771808 | Derrick Anthony Davis | Physician Assistant | 320 S Flamingo Rd, # 112, Pembroke Pines, FL 33027-1770 | 2007-01-31 |
| 1245739986 | Derrick Davis | Counselor | 3100 Euclid Ave, Cleveland, OH 44115-2508 | 2018-02-08 |
| Street Address |
1063 DUCKWOOD DR APT 205 |
| City | EAGAN |
| State | MN |
| Zip Code | 55123-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053828467 | Hilltop Family Chiropractic Center Pa | Chiropractor | 1121 Town Centre Drive Suite 202, Eagan, MN 55123 | 2018-01-08 |
| 1922452507 | Jacob Zimmerman | Counselor | 3450 O'leary Ln., Eagan, MN 55123 | 2016-04-20 |
| 1316320971 | K-squared Fitness, L.L.C. | Public Health or Welfare | 1100 Cliff Rd, Eagan, MN 55123 | 2015-07-01 |
| 1346683687 | Joshua M Dorn | Allergy & Immunology | 3460 Promenade Ave, Eagan, MN 55123 | 2013-04-16 |
| 1700172350 | Mary Christine Mcnabney | Nurse Practitioner | 610 Opperman Drive, D4 Health Center, Your Wellbeing Health Center, Eagan, MN 55123 | 2011-06-22 |
| 1033353669 | Todd Borstad | Social Worker | 3450 O'leary Lane, Eagan, MN 55123 | 2009-04-27 |
| 1821025271 | Mngi Endoscopy LLC | Clinic/Center | 1185 Town Centre Drive, Eagan, MN 55123 | 2006-06-28 |
| 1780620120 | Cindy Eileen Wood | Audiologist | 3440 Oleary Lane, 240, Eagan, MN 55123 | 2006-06-22 |
| 1609845742 | Jeffery R Dichter | Internal Medicine | 849 Govern Circle, Saint Paul, MN 55123 | 2006-03-14 |
| 1891269155 | Elise Broderick Quam | Social Worker | 3450 Oleary Ln, Eagan, MN 55123 | 2019-01-18 |
| Find all providers in zip 55123 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154928927 | Heidi Frey | Specialist/Technologist | 4554 Lake Park Ct, Eagan, MN 55122-2515 | 2020-10-05 |
| 1619531498 | Taylor Whitney | Specialist/Technologist | 505 Weston Hills Pl, Eagan, MN 55123-3981 | 2019-04-26 |
| 1265974398 | Jana Elliott | Specialist/Technologist | 4969 Sycamore Dr, Eagan, MN 55123-4913 | 2016-11-07 |
| 1588025134 | Brian Kennedy | Specialist/Technologist | 576 Hawthorne Woods Dr, Eagan, MN 55123-3059 | 2016-03-10 |
| 1700268828 | Kara Beth Rose | Specialist/Technologist | 4560 Cinnamon Ridge Trail, Eagan, MN 55122 | 2015-06-25 |
| 1588785265 | Bradley Dean Mack | Specialist/Technologist | 4185 Braddock Trl, Eagan, MN 55123-1575 | 2007-04-02 |
| 1376999052 | Kaitlyn Jensen | Specialist/Technologist | 4185 Braddock Trl, Eagan, MN 55123-1575 | 2016-05-11 |
| 1992113534 | Nicholas Dephillipo | Specialist/Technologist | 2700 Vikings Cir, Eagan, MN 55121 | 2014-07-28 |
| 1639510845 | Anna Lynn Connelly | Specialist/Technologist | 1185 Town Centre Dr, Suite 100, Eagan, MN 55123-1187 | 2013-07-16 |
| 1295019388 | Jesse Lee Fladmark | Specialist/Technologist | 1654 Diffley Rd, 100, Eagan, MN 55122-2237 | 2011-10-06 |
| Find all providers in EAGAN | ||||
Please comment or provide details below to improve the information on DERRICK DAVIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.