Active NPI
Luke A Davis, CNP
- Family Nurse Practitioner
- Tiffin, OH
National Provider Identifier
1073869905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- COA13524-NP
- Practice address
- 486 W Perry St
Tiffin, OH 44883-1902 - Phone
- (419) 455-8140
- Fax
- (419) 225-8878
- NPI assigned
- Jul 30, 2012
- Last updated
- Aug 13, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | COA13524-NP | OH | Primary |
Addresses
Primary practice location
486 W Perry St
Tiffin, OH 44883-1902
Mailing address
441 E 8TH St
Lima, OH 45804-2482
Phone (419) 221-3072
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0069300 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
540 W Central Ave
Springboro, OH 45066-1110
Phone (513) 847-6778
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA13524-NP | OH | MD | Family Nurse Practitioner |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439424000000",
"number": "1073869905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "441 E 8TH ST",
"city": "LIMA",
"state": "OH",
"postal_code": "458042482",
"telephone_number": "419-221-3072",
"fax_number": "419-225-8878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "486 W PERRY ST",
"city": "TIFFIN",
"state": "OH",
"postal_code": "448831902",
"telephone_number": "419-455-8140",
"fax_number": "419-225-8878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LUKE",
"middle_name": "A",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-30",
"last_updated": "2015-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "COA13524-NP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0069300",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tiffin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2015; 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.