Mr Phillip Alan Davis, LSW in Rockford, IL - Medicare Social Worker Provider

Mr Phillip Alan Davis, LSW is a medicare enrolled "Social Worker - Clinical" provider in Rockford, Illinois. His current practice location is 1021 N Mulford Rd, Rockford, Illinois. You can reach out to his office (for appointments etc.) via phone at (888) 928-0212.

Mr Phillip Alan Davis is licensed to practice in Illinois (license number 149.027614) 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 1891370201.

Contact Information

	Mr Phillip Alan Davis, LSW
	1021 N Mulford Rd, Rockford, IL 61107-3874
	(888) 928-0212
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Phillip Alan Davis
Gender	Male
Speciality	Social Worker - Clinical
Location	1021 N Mulford Rd, Rockford, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1891370201
Provider Enumeration Date: 03/17/2021
Last Update Date: 09/27/2025

Medicare PECOS Information:

PECOS PAC ID: 4981125333
Enrollment ID: I20250303000843

Medical Identifiers

Medical identifiers for Mr Phillip Alan Davis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1891370201	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	149.027614 (Illinois)	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. Mr Phillip Alan Davis allows following entities to bill medicare on his behalf.

Entity Name	Cmc Healthcare Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295432334 PECOS PAC ID: 4688039209 Enrollment ID: O20230503001140

Entity Name	Edgewood Clinical Services P.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1295914646 PECOS PAC ID: 3971963901 Enrollment ID: O20230721001228

Entity Name	Sondermind Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003646977 PECOS PAC ID: 0547795791 Enrollment ID: O20241125001063

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. Mr Phillip Alan 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
Mr Phillip Alan Davis, LSW 1021 N Mulford Rd, Rockford, IL 61107-3874 Ph: (888) 928-0212	Mr Phillip Alan Davis, LSW 1021 N Mulford Rd, Rockford, IL 61107-3874 Ph: (888) 928-0212

Reviews and Comments

Social Worker in Rockford, IL

Kelly Finch, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 4320 Spring Creek Rd, Ste 19, Rockford, IL 61107 Phone: 815-222-9485
Mrs. Jessica M Gregg, MSW LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5758 Elaine Dr Ste 101c, Rockford, IL 61108 Phone: 815-975-1177
Miss Marcy L Turek, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1601 Parkview Ave, University Psychiatric Services, Rockford, IL 61107 Phone: 815-395-5874 Fax: 815-395-5644
Stephanie A Johnson, LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 4835 Manhattan Dr Ste 4, Rockford, IL 61108 Phone: 815-520-2303
Claire Vasquez, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4410 Saint Annes Way, Rockford, IL 61114 Phone: 847-456-7425
Dana Stephen Kiley, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2823 Glenwood Ave, Rockford, IL 61101 Phone: 815-968-5342 Fax: 815-968-4656
Paula Tripodi, L.C.S.W. Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 6735 Vistagreen Way Ste 210, Rockford, IL 61107 Phone: 815-742-7489 Fax: 815-904-6419

Mr Phillip Alan Davis, LSW - Medicare Clinical Social Worker in Rockford, IL