Sheila Ann Davis, PHD
Individual provider Active NPI Family Nurse Practitioner · Byram, MS
NPI 1013384577 · NPPES record last updated Dec 9, 2016
Key facts
- NPI
- 1013384577
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R859652 (MS)
- Practice address
- 6644 Gary Road
Suite D Box 720448
Byram, MS 39272-9600 - Phone
- (769) 572-5158
- Fax
- (769) 572-5158
- NPI assigned
- Aug 31, 2015
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220720003458 | CA | Practitioner - Nurse Practitioner | 9638453137 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN24693 | GA | MD | Family Nurse Practitioner |
| R859652 | MS | MD | Family Nurse Practitioner |
| 199994 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Newstart Medical Group Inc | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R859652 | MS | Yes |
| Family Nurse Practitioner | 363LF0000X | RN24693 | GA | |
| Family Nurse Practitioner | 363LF0000X | 199994 | TN |
Addresses
Primary practice location
6644 Gary Road
Suite D Box 720448
Byram, MS 39272-9600
Mailing address
P.O. Box 720448
6644 Gary Road Suite D,
Byram, MS 39272-9600
Phone (769) 572-5158
Other providers in Byram, MS
- Daniels Transportation Services,LLC
- Davis Healthcare Facility
- Demadria Davis
- Naomi Davis
- Scott Anderson Davis
- Delivery Me, LLC
- Dewona Flowers
- John Anthony Dickson
- Drayer Physical Therapy Institute LLC
- Drayer Physical Therapy Jackson LLC
All providers in Byram, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.