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Deactivated NPI 1093475121 Deactivated / Inactive NPI Male Practitioner

Carl J Davis , CRT

Prevention Professional • Springfield, MO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Carl Davis has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 30, 2021
NPI Deactivation Date July 23, 2024
Total Practice Duration ~3 Years of Practice (2021 – 2024)

Professional Overview & Biography Verified Profile Summary

Carl Davis, CRT was a registered Prevention Professional practicing in Springfield, MO. Throughout an active medical career spanning 3 years, Carl Davis provided care at the practice location at 2240 W SUNSET ST STE 100 until profile deactivation on 2024-07-23.

Practice Location & Contact Primary Location

Practice Address

2240 W Sunset St Ste 100

Springfield, MO 658076041

Telephone 4172694663
Fax 4172690692
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Prevention Professional in Springfield, MO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
6 Specialists

Practicing in Springfield, MO (21 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Prevention Professional Primary Specialty

NUCC Taxonomy Code: 405300000X

State License MO 100332

Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Shelly Jones , RRT

Prevention Professional

NPI 1114657939

Registered Respiratory Therapist

Melissa Willhite , RRT

Prevention Professional

NPI 1194454504

Registered Respiratory Therapist

Stephanie Mcgarity , FNP

Nurse Practitioner

NPI 1649830290

Family Nurse Practitioner

Lori Wilson , AS CRT-CPFT

Prevention Professional

NPI 1649921511

ASCRTCPFT

Kristie Weihe

Prevention Professional

NPI 1790437242
Dr. Robert Kensel , MD

Emergency Medicine

NPI 1811978505

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 23, 2024

Record deactivated on July 23, 2024

NPI Profile Active December 30, 2021

NPI status registered as active in NPPES database

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Updated Practice Location December 30, 2021

Registered at 2240 W SUNSET ST STE 100, SPRINGFIELD, MO 658076041 (Tel: 4172694663)

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Updated Business Mailing Address December 30, 2021

Registered at 2240 W SUNSET ST STE 100, SPRINGFIELD, MO 658076041 (Tel: 4172694663)

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Provider Name / Credentials Updated December 30, 2021

Recorded as CARL DAVIS, CRT

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 30, 2021

Prevention Professional (License #100332 in MO)

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Initial NPI Registration & Enumeration December 30, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1093475121
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 30, 2021
Last Update: December 30, 2021
Deactivation Date: July 23, 2024

Mailing Address

2240 W Sunset St Ste 100

Springfield, MO 658076041

Phone: 4172694663

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.