Billy Wayne Davis, FNP-BC

Key facts

NPI

1023324167

Entity type

Individual (NPI type 1)

Primary specialty

Family Nurse Practitioner 363LF0000X

License

60155 (WV)

Practice address

HC 73 Box 6
Glen Fork, WV 25845-8824

Phone

(304) 682-4425

NPI assigned

Aug 26, 2010

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 26, 2010.

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1023324167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 73 BOX 6",
            "city": "GLEN FORK",
            "state": "WV",
            "postal_code": "258458824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 73 BOX 6",
            "city": "GLEN FORK",
            "state": "WV",
            "postal_code": "258458824",
            "telephone_number": "304-682-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BILLY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-26",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "60155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Fork, WV

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All providers in Glen Fork, WV · Family Nurse Practitioner in West Virginia