Liesa A Davis, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

COA.15925-NP Issued in OH

Practice address

4640 W Alexis Rd
Toledo, OH 43623-1182

Phone

(419) 474-9324

Fax

(855) 287-0160

NPI assigned

Oct 13, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Liesa A Brand Former name

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Toledo Medical College, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

ENT Physicians IncGroup PAC ID 6103724935, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
• Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
• Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• ENT Physicians Inc

  • Otolaryngology Physician
  • Toledo, OH
  • NPI 1871692996
  Medicare reassignment Care Compare group NPD
• Wood Health Company LLC

  • Family Medicine Physician
  • Bowling Green, OH
  • NPI 1598776916
  NPD

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

• Bay Park Community Hospital

  • General Acute Care Hospital
  • Oregon, OH
  • NPI 1598765539
  Care Compare affiliation
• Mercy Health - St Vincent Medical Center LLC

  dba Mercy Health St Vincent Medical Center

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1467493551
  Care Compare affiliation
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Care Compare affiliation
• Toledo Hospital

  dba ProMedica Transportation Network

  • Ambulance
  • Toledo, OH
  • NPI 1427147339

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1083018501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 W ALEXIS RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436231182",
            "telephone_number": "419-474-9324",
            "fax_number": "552-870-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 W ALEXIS RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436231182",
            "telephone_number": "419-474-9324",
            "fax_number": "855-287-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LIESA",
        "middle_name": "A",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.15925-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0112089",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "liesa.daviscnp.p1@direct.whc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1616 E Wooster St Unit 38",
            "city": "Bowling Green",
            "state": "OH",
            "country_code": "US",
            "postal_code": "434023478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LIESA",
            "last_name": "BRAND",
            "middle_name": "A",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kenyatta Dashawn Davis, LPN
• Kimberly Anne Davis
• Kirk R. Davis, D.O.
• Kristen Marie Davis
• Laura E Davis, CNP
• Lorraine H Davis
• Madeleine Davis
• Malaikah Davis
• Marquetta A Davis
• Maryasha Davis

• Family Nurse Practitioner in Toledo, OH
• Providers in Toledo, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.