Amanda Ann Davis, NP
Individual provider Active NPI Family Medicine Physician · Willcox, AZ
NPI 1043850795 · NPPES record last updated May 11, 2020
Key facts
- NPI
- 1043850795
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 236319 (AZ)
- Practice address
- 801 W Rex Allen Dr
Willcox, AZ 85643-1129 - Phone
- (520) 766-5000
- Fax
- (520) 766-5001
- NPI assigned
- Jan 10, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Walker Family Medicine PLC
Practice addresses (Care Compare)
801 W Rex Allen Dr
Wilcox, AZ 85643-1129
Phone (520) 766-5000
Hospital & facility affiliations
- Home Health Safford, LLC
- Northern Cochise Community Hospital, Inc.
- Benson Hospital
- Mt. Graham Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- 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 |
|---|---|---|---|---|
| I20200203000233 | AZ | Practitioner - Nurse Practitioner | 8527494079 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walker Family Medicine PLC | Family Medicine | Current |
Accepting new patients |
| Walker Family Medicine PLC | Family Medicine | Current |
Accepting new patients |
| Old Pueblo Mobile Medicine LLC | Family Medicine | Past |
Accepting new patients |
Locations
611 W Union St
Benson, AZ 85602
Phone (520) 586-0800
801 W Rex Allen Dr
Willcox, AZ 85643
Phone (520) 766-5000
Interoperability endpoints
- amandadavis_35094@wfm.omnimddirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 236319 | AZ | Yes |
Addresses
Primary practice location
801 W Rex Allen Dr
Willcox, AZ 85643-1129
Mailing address
801 W Rex Allen Dr
Willcox, AZ 85643-1129
Phone (520) 766-5000
Other providers in Willcox, AZ
- Jeffery Burl Bushman
- Abby F Camisa
- Charles WM. Leighton Jr Hospice, Inc.
- Child & Family Resources, Inc.
- Chiricahua Community Health Centers, Inc.
- Sunny Lynn De Baun
- Angela Diaz
- Joshua M Dopko
- Kristine Beth Duncan
- Frances Weaver Grill
All providers in Willcox, AZ · Family Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2020. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.