Larissa Davis

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN197160 Issued in GA

Practice address

200 Doctors Dr
Ste 201
Douglas, GA 31533-2201

Phone

(912) 384-9460

Fax

(912) 393-1239

NPI assigned

Apr 22, 2014

Last updated

Sep 6, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: larissa.davis@337577483108356.direct.elationemr.com

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.

• Coffee Emergency Group LLC

  • Emergency Medicine Physician
  • Douglas, GA
  • NPI 1023353489
  Medicare reassignment NPD
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment NPD
• CRH Physician Practices LLC

  dba CRH Pediatric Group

  • Pediatrics Physician
  • Douglas, GA
  • NPI 1255682142
  NPD (past)

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504656000000",
    "number": "1063832731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WARD ST EXT W",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315341902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR",
            "address_2": "STE 201",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332201",
            "telephone_number": "912-384-9460",
            "fax_number": "912-393-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LARISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-22",
        "last_updated": "2017-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN197160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "RN197160",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003145835A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chloe V Darwin, PHARMD, RPH
• Bobbie Davonna Davis
• Jaime Davis, MD
• Jennifer Kay Davis, NP
• Katie Evans Davis, NP-C
• Amber Marie Dawson, FNP-C
• Kaci Brooke Day, R.D. L.D.
• Rachel Christian Dean, NP
• Debbie L. Dismuke D.M.D.,P.C.
• Kenneth P Depersio, MD

• Family Nurse Practitioner in Douglas, GA
• Providers in Douglas, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.