Individual provider Active NPI

Cristyn Rene Davis, MSN, APRN, FNP-C

  • Nurse Practitioner
  • Glen Dale, WV
National Provider Identifier
1033708573
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
108102 Issued in WV
Practice address
426 8TH St Ste 305
Glen Dale, WV 26038-1451
Phone
(304) 559-3491
NPI assigned
Jan 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 108102 WV Primary

Addresses

Primary practice location

426 8TH St Ste 305
Glen Dale, WV 26038-1451

Mailing address

426 8TH St Ste 305
Glen Dale, WV 26038-1451
Phone (304) 559-3491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231227001794 WV Practitioner - Nurse Practitioner 4082064456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reynolds Memorial Hospital, IncGroup PAC ID 9830184530, 152 clinicians

Practice addresses (Care Compare)

407 Wheeling Ave
Glen Dale, WV 26038-1536
Phone (304) 845-1500

Hospital & facility affiliations

  • Reynolds Memorial Hospital, Inc Hospital, Glen Dale, WV, CCN 510013

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
108102WVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reynolds Memorial Hospital, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Reynolds Memorial Hospital, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

800 Wheeling Ave
Glen Dale, WV 26038
Phone (304) 221-4520

407 Wheeling Ave
Glen Dale, WV 26038
Phone (304) 221-3012

100 Teletech Dr
Ste 3
Moundsville, WV 26041
Phone (304) 221-3012

159 Edgington Ln
Wheeling, WV 26003
Phone (304) 242-1093

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1033708573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 8TH ST STE 305",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381451",
            "telephone_number": "304-559-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 8TH ST STE 305",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381451",
            "telephone_number": "304-559-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CRISTYN",
        "middle_name": "RENE",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "108102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Dale, WV

Sources for this page

Verify at the official NPI Registry.