Individual provider Active NPI

Jill Davis, FNP-C

  • Family Nurse Practitioner
  • Daniels, WV
National Provider Identifier
1093698763
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
106156 Issued in WV
Practice address
117 Martin St
Daniels, WV 25832-9761
Phone
(304) 573-7485
NPI assigned
Jul 29, 2025
Last updated
Jul 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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 106156 WV Primary

Addresses

Primary practice location

117 Martin St
Daniels, WV 25832-9761

Mailing address

117 Martin St
Daniels, WV 25832-9761
Phone (304) 573-7485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20251105002218 WV Practitioner - Nurse Practitioner 4082104443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

117 Martin St
Daniels, WV 25832-9761

PO Box
Suite 283
Stanaford, WV 25927

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106156WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alwahhab PLLC CurrentSince Aug 10, 2025 Accepting new patients

Locations

2233 S Kanawha St
Beckley, WV 25801
Phone (304) 250-7611

Interoperability endpoints

  • Direct secure messaging: jill.davis.1@9060.direct.athenahealth.com

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.

Hospital & facility affiliations 3

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": "1753747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1093698763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 MARTIN ST",
            "city": "DANIELS",
            "state": "WV",
            "postal_code": "258329761",
            "telephone_number": "304-573-7485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MARTIN ST",
            "city": "DANIELS",
            "state": "WV",
            "postal_code": "258329761",
            "telephone_number": "304-573-7485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JILL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-29",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "106156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daniels, WV

Sources for this page

Verify at the official NPI Registry.