Individual provider Active NPI

Cassandra Davis, FNP-BC

  • Family Nurse Practitioner
  • Atlantic Beach, NC
National Provider Identifier
1073937397
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5006733 Issued in NC
Practice address
201 W Fort Macon Rd
Atlantic Beach, NC 28512-5303
Phone
(252) 773-0841
Fax
(252) 773-0737
NPI assigned
Feb 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5006733 NC Primary

Addresses

Primary practice location

201 W Fort Macon Rd
Atlantic Beach, NC 28512-5303

Mailing address

150 Ray Davis Rd
Marshallberg, NC 28553-9728
Phone (252) 725-3844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160822002943 NC Practitioner - Nurse Practitioner 9537454178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

201 W Fort Macon Rd
Atlantic Beach, NC 28512-5303
Phone (252) 773-0841

Hospital & facility affiliations

  • Carteret General Hospital Hospital, Morehead City, NC, CCN 340142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Complexion Medical Spa PLLC Family CurrentSince Feb 1, 2023 Accepting new patients

Locations

201 W Fort Macon Rd
Atlantic Beach, NC 28512
Phone (252) 773-0841

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1073937397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 RAY DAVIS RD",
            "city": "MARSHALLBERG",
            "state": "NC",
            "postal_code": "285539728",
            "telephone_number": "252-725-3844",
            "fax_number": "252-773-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W FORT MACON RD",
            "city": "ATLANTIC BEACH",
            "state": "NC",
            "postal_code": "285125303",
            "telephone_number": "252-773-0841",
            "fax_number": "252-773-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CASSANDRA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-06",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5006733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic Beach, NC

Sources for this page

Verify at the official NPI Registry.