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Deactivated NPI 1902462500 Deactivated / Inactive NPI Male Practitioner

Shane Davison

Counselor - Professional • Rosharon, TX

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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, Shane Davison has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 20, 2019
NPI Deactivation Date May 21, 2019
Total Practice Duration ~1 Years of Practice (2019 – 2019)

Professional Overview & Biography Verified Profile Summary

Shane Davison was a registered Counselor - Professional practicing in Rosharon, TX. Throughout an active medical career spanning 1 years, Shane Davison provided care at the practice location at 9514 OCEAN DR until profile deactivation on 2019-05-21.

Practice Location & Contact Primary Location

Practice Address

9514 Ocean Dr

Rosharon, TX 775831603

Telephone 2812417163
Associated Practice Facility / Clinic
🏢 Scp Davison, Pllc Facility NPI 1467252635

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Rosharon, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.0 Yrs
State Avg: 14.1 Yrs
Regional Practice Density
16 Specialists

Practicing in Rosharon, TX (21203 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

CMS Verified: 2025-03-17
Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License TX 78160

Definition to come...

Career & Practice History Timeline

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

8 Historical Events
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Updated Practice Location March 17, 2025

Registered at 9514 OCEAN DR, ROSHARON, TX 775831603 (Tel: 2812417163)

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NPI Profile Reactivated June 10, 2019

Record officially reactivated for active practice on June 10, 2019

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Updated Practice Location June 10, 2019

Registered at 210 LAKE RD STE 700A, LAKE JACKSON, TX 775664988 (Tel: 9792859242)

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Updated Business Mailing Address June 10, 2019

Registered at 9514 OCEAN DR, IOWA COLONY, TX 775831603 (Tel: 2816301113)

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Provider Name / Credentials Updated June 10, 2019

Recorded as SHANE DAVISON

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 10, 2019

Counselor (License #78160 in TX)

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NPI Profile Deactivated May 21, 2019

Record deactivated on May 21, 2019

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Initial NPI Registration & Enumeration May 20, 2019

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: 1902462500
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 20, 2019
Last Update: March 17, 2025
Deactivation Date: May 21, 2019
Sole Proprietor: No

Mailing Address

9514 Ocean Dr

Iowa Colony, TX 775831603

Phone: 2816301113

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.