Shane K Davis, LMHC is a medicare enrolled "Psychologist - Counseling" provider in Bradenton, Florida. His current practice location is
5325 E State Road 64 Ste B, Bradenton, Florida. You can reach out to his office (for appointments etc.) via phone at
(941) 277-9922.
Shane K Davis is licensed to practice in Michigan (license number 6361001470) 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 1689822686.
Healthcare Provider's Profile
| Full Name | Shane K Davis |
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| Gender | Male |
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| Speciality | Psychologist - Counseling |
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| Location | 5325 E State Road 64 Ste B, Bradenton, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1689822686
- Provider Enumeration Date: 09/03/2008
- Last Update Date: 07/23/2026
Medicare PECOS Information:
- PECOS PAC ID: 4880038637
- Enrollment ID: I20240220002322
Medical Identifiers
Medical identifiers for Shane K Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1689822686 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | MH23035 (Florida) | Secondary |
| 103TC1900X | Psychologist - Counseling | 6361001470 (Michigan) | 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. Shane K Davis allows following entities to bill medicare on his behalf.
| Entity Name | Grow Healthcare Group PA |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245845932
PECOS PAC ID: 3476961368
Enrollment ID: O20210414000053 |
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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. Shane K 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 |
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Shane K Davis, LMHC
5325 E State Road 64 Ste B,
Bradenton, FL 34208-5534
Ph: (941) 277-9922 | Shane K Davis, LMHC
5325 E State Road 64 Ste B,
Bradenton, FL 34208-5534
Ph: (941) 277-9922 |
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