Individual provider Active NPI

Laneita R Davis, N.P.

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1073828802
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15148 Issued in TN
Practice address
360 E Eh Crump Blvd
Memphis, TN 38126-5394
Phone
(901) 261-7387
Fax
(901) 261-7387
NPI assigned
Aug 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R868500 MS
Family Nurse Practitioner 363LF0000X 15148 TN Primary

Addresses

Primary practice location

360 E Eh Crump Blvd
Memphis, TN 38126-5394

Mailing address

4545 Boxwood LN
Horn Lake, MS 38637-8538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20110613000444 TN Practitioner - Nurse Practitioner 8628255015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Memphis Health Center, Inc.Group PAC ID 7315859972, 17 clinicians

Practice addresses (Care Compare)

360 E Eh Crump Blvd
Memphis, TN 38126-5310
Phone (901) 261-2025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R868500MSMDRegistered Nurse
15148TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memphis Health Center, Inc. CurrentSince Dec 18, 2024 Accepting new patients
Memphis Health Center, Inc. CurrentSince Dec 18, 2024 Accepting new patients
Well Child Inc. Past Accepting new patients

Locations

4593 Elvis Presley Blvd
Ste 101
Memphis, TN 38116
Phone (901) 261-2000

360 E Eh Crump Blvd
Memphis, TN 38126
Phone (901) 261-2000

4940 Highway 57
Rossville, TN 38066
Phone (901) 261-2221

4940 Highway 57
Ste 107
Rossville, TN 38066
Phone (901) 261-2221

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1073828802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 BOXWOOD LN",
            "city": "HORN LAKE",
            "state": "MS",
            "postal_code": "386378538",
            "fax_number": "901-261-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 E EH CRUMP BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381265394",
            "telephone_number": "901-261-7387",
            "fax_number": "901-261-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LANEITA",
        "middle_name": "R",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "R868500",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "15148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.