Andrea Venus Davies, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71009851A Issued in IN

Practice address

4320 Fir St Unit 313
East Chicago, IN 46312-3078

Phone

(219) 392-7424

NPI assigned

Dec 5, 2019

Last updated

Jul 9, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Prof. Andrea Venus Davies Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Community Care Network Inc

  dba Powers Health Medical Group

  • Family Medicine Physician
  • Saint John, IN
  • NPI 1457610487

  Nurse Practitioner

  NPD

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1033756341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "219-392-7084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 FIR ST UNIT 313",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123078",
            "telephone_number": "219-392-7424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3170 Willowcreek Rd",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "IN",
            "postal_code": "463684424",
            "country_code": "US",
            "telephone_number": "219-941-6628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIES",
        "first_name": "ANDREA",
        "middle_name": "VENUS",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-05",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28180308A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71009851A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "DAVIES",
            "middle_name": "VENUS",
            "prefix": "PROF.",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Judith A Cullom, BA
• Michael Charles Cummins
• Kenosha Currie, CNA
• Mira Damnjanovic
• India M Daniels, RBT
• Denise Davis-Mulligan
• Crystal Joy Davis
• Stephane Bernard Degraff, MD
• Melissa Lynn Del Rosario
• Irmani Juanita Dewman

• Nurse Practitioner in East Chicago, IN
• Providers in East Chicago, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.