Individual provider Active NPI

Robert Benjamin Davis, RN, FNP

  • Family Nurse Practitioner
  • Charlottesville, VA
National Provider Identifier
1083601017
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024164923 Issued in VA
Practice address
500 Ray C Hunt Dr
Charlottesville, VA 22903-2981
Phone
(434) 982-6599
Fax
(434) 243-5692
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroscience Registered Nurse 163WN0800X 0001133791 VA
Family Nurse Practitioner 363LF0000X 0024164923 VA Primary

Addresses

Primary practice location

500 Ray C Hunt Dr
Charlottesville, VA 22903-2981

Mailing address

500 Ray C Hunt Dr
Charlottesville, VA 22903-2981
Phone (434) 982-6599

Other identifiers 1

IdentifierTypeStateIssuer
252429MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001133791VAMDNeuroscience Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1083601017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 RAY C HUNT DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032981",
            "telephone_number": "434-982-6599",
            "fax_number": "434-243-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 RAY C HUNT DR",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229032981",
            "telephone_number": "434-982-6599",
            "fax_number": "434-243-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROBERT",
        "middle_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "RN, FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neuroscience",
            "state": "VA",
            "license": "0001133791",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024164923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252429",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.