Active NPI
Janielle Tenise Davis, LPN
- Licensed Practical Nurse
- Dayton, OH
National Provider Identifier
1063161248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 161583
- Practice address
- 4124 Linden Ave
Dayton, OH 45432-3018 - Phone
- (937) 522-0961
- Fax
- (937) 522-0951
- NPI assigned
- Mar 23, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 161583 | OH | Primary |
Addresses
Primary practice location
4124 Linden Ave
Dayton, OH 45432-3018
Mailing address
2843 Louella Ave
Dayton, OH 45417-4213
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 161583 | OH | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornerstone Project, LLC | Current | Accepting new patients |
Locations
4124 Linden Ave
Dayton, OH 45432
Phone (937) 522-0961
Organizations & group practices 1
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.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Dayton, OH
- NPI 1639609548
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647993600000",
"number": "1063161248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2843 LOUELLA AVE",
"city": "DAYTON",
"state": "OH",
"postal_code": "454174213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4124 LINDEN AVE",
"city": "DAYTON",
"state": "OH",
"postal_code": "454323018",
"telephone_number": "937-522-0961",
"fax_number": "937-522-0951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JANIELLE",
"middle_name": "TENISE",
"name_prefix": "Ms.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-23",
"last_updated": "2022-03-23",
"certification_date": "2022-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "161583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.