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TYSON DAVIS
NPI 1417205774
Psychologist - Clinical in Austin, TX

Active since August 16, 2012Opted out of Medicare · through Jan 1, 2027
1515 S CAPITAL OF TEXAS HWY, STE 200, AUSTIN, TX 78746(512) 767-1136 Get Directions Write a Review

NPPES record last updated: February 18, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 18, 2020, May 18, 2016 (2 updates tracked since 2016).

About Tyson Davis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYSON DAVIS (NPI 1417205774) is an individual clinical provider in Austin, Texas, licensed in Pennsylvania (PS017720) and active in the NPI registry since August 2012. He has opted out of Medicare through January 1, 2027.

NPPES Registry Identity

NPI1417205774
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameTYSON DAVIS
Location Address1515 S CAPITAL OF TEXAS HWY, STE 200Austin, TX 78746-6544
Mailing Address1515 S Capital Of Texas Hwy, Ste 200Austin, TX 78746-6544 · (512) 767-1136
Phone(512) 767-1136
Sole ProprietorYes
Enumeration DateAugust 16, 2012
Last NPPES UpdateFebruary 18, 20202 updates tracked since enumeration
✔ NPI 1417205774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
Licenses✔ Licensed in PA · PS017720✔ Licensed in TX · 38201
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
1515 S CAPITAL OF TEXAS HWY, Austin, TX 78746
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Tyson Davis has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2025 through January 1, 2027.

Opt-Out Effective DateJanuary 1, 2025
Opt-Out In Effect ThroughJanuary 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CLAIRE FRANCES HILL APRN, PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
1515 S CAPITAL OF TEXAS HWY
AUSTIN, TX 78746
Travis County (651) 235-9890
DR. CAROLYN COLE BREAZEALE D.C.
Chiropractor
1515 S CAPITAL OF TEXAS HWY, SUITE 220
AUSTIN, TX 78746
Travis County (512) 328-3881
EMILY DRUE ROBERTS MA, LPC
Counselor
1515 S CAPITAL OF TEXAS HWY, SUITE 300
AUSTIN, TX 78746
Travis County (512) 736-6743
DR. PAUL QUENTIN BREAZEALE D.C.
Chiropractor
1515 S CAPITAL OF TEXAS HWY, SUITE 220
AUSTIN, TX 78746
Travis County (512) 328-3881

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tyson Davis's NPI number?

The NPI number for Tyson Davis is 1417205774. It was assigned to this individual provider in the NPPES registry on August 16, 2012.

Where is Tyson Davis located?

Tyson Davis practices at 1515 S Capital Of Texas Hwy Ste 200, Austin, TX 78746. The listed phone number is (512) 767-1136.

What is Tyson Davis's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Tyson Davis enrolled in Medicare?

No. Tyson Davis has opted out of Medicare through January 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Tyson Davis was last updated on February 18, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.