Robert Davis, MED in Randolph, VT - Medicare Counselor Provider

Robert Davis, MED is a medicare enrolled "Counselor - Mental Health" provider in Randolph, Vermont. His current practice location is 11 N Main St, Randolph, Vermont. You can reach out to his office (for appointments etc.) via phone at (802) 728-4466.

Robert Davis is licensed to practice in Vermont (license number 0680000714) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1154511459.

Contact Information

	Robert Davis, MED
	11 N Main St, Randolph, VT 05060-1126
	(802) 728-4466
	(802) 728-4197

Healthcare Provider's Profile

Full Name	Robert Davis
Gender	Male
Speciality	Counselor - Mental Health
Location	11 N Main St, Randolph, Vermont
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1154511459
Provider Enumeration Date: 08/01/2007
Last Update Date: 08/01/2007

Medicare PECOS Information:

PECOS PAC ID: 6800249087
Enrollment ID: I20240124004021

Medical Identifiers

Medical identifiers for Robert Davis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154511459	NPI	-	NPPES
2393212	Other	VT	CIGNA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	0680000714 (Vermont)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Robert Davis allows following entities to bill medicare on his behalf.

Entity Name	Clara Martin Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1386710861 PECOS PAC ID: 1951395367 Enrollment ID: O20060315000608

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Robert Davis is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Robert Davis, MED 190 Sugar Plum Ct, Randolph, VT 05060-9379 Ph: (802) 728-6459	Robert Davis, MED 11 N Main St, Randolph, VT 05060-1126 Ph: (802) 728-4466

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Counselor in Randolph, VT

Renee Weeks, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 S Main St, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197
David Pellegrino, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 S Main St, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197
Jessica Schupp, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 Main Street, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197
Howard Hood, LCMHC Counselor Medicare: Medicare Enrolled Practice Location: 11 S Main St, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197
Adam Bindrum, Counselor Medicare: Medicare Enrolled Practice Location: 11 N Main St, Randolph, VT 05060 Phone: 802-728-4466
Kara Rebecca Toms, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 N Main St, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197
Kerrie Taylor, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 S Main St, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197

Robert Davis, MED - Medicare Counselor in Randolph, VT

Contact Information

Healthcare Provider's Profile

Medical Identifiers

Medical Taxonomies and Licenses

Medicare Reassignments

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Medicare Part D Prescriber Enrollment

Mailing Address and Practice Location

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Counselor in Randolph, VT