Justin William Davis, MSN, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3013878 Issued in KY

Practice address

110 W John Rowan Blvd
Bardstown, KY 40004-2663

Phone

(502) 337-7409

NPI assigned

Oct 18, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

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 and National Provider Directory roles.

• Brock Medical, LLC

  • Nurse Practitioner
  • London, KY
  • NPI 1023379815
  Medicare reassignment NPD
• Fast Pace Kentucky PLLC

  • Rural Health Clinic/Center
  • Corbin, KY
  • NPI 1669256913
  NPD

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1043853302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 SIMPSON CREEK RD",
            "city": "BLOOMFIELD",
            "state": "KY",
            "postal_code": "400086110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W JOHN ROWAN BLVD",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400042663",
            "telephone_number": "502-337-7409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JUSTIN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-18",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylin Michelle Dalton, PHLEBOTOMIST
• Darlena K Smith
• Darlena K Smith LLC
• Davis Cosmetic and Family Dentistry, PLLC
• Jasen Conner Davis, MD
• Lakeisha Carol Davis, D.M.D.
• Megan Mae Davis, MSN, APRN, FNP-C
• Franklin O De la Cruz, M.D.
• Dearinger & Klindt CCC PLLC
• Beaman N Dearinger, DC

• Family Nurse Practitioner in Bardstown, KY
• Providers in Bardstown, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; 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.