Individual provider Active NPI

Heather Nicole Davis, APRN

  • Family Nurse Practitioner
  • Barbourville, KY
National Provider Identifier
1104423383
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3015202 Issued in KY
Practice address
215 Treuhaft Blvd Ste 8
Barbourville, KY 40906-7361
Phone
(606) 277-0173
Fax
(606) 277-0045
NPI assigned
Oct 1, 2020
Last updated
Oct 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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 3015202 KY Primary

Addresses

Primary practice location

215 Treuhaft Blvd Ste 8
Barbourville, KY 40906-7361

Mailing address

215 Treuhaft Blvd Ste 8
Barbourville, KY 40906-7361
Phone (606) 277-0173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20201210001928 KY Practitioner - Nurse Practitioner 0648682989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newborn and Kids Health Center IncGroup PAC ID 0547564775, 3 clinicians

Practice addresses (Care Compare)

215 Treuhaft Blvd
Suite 8
Barbourville, KY 40906-7361
Phone (606) 277-0173

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3015202KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Newborn & Kids Health Center, Inc. CurrentSince Nov 6, 2020 Accepting new patients

Locations

215 Treuhaft Blvd
Ste 8
Barbourville, KY 40906
Phone (606) 277-0173

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HGEDAD/Endpoint/HGEDAD

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 2

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": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1104423383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 TREUHAFT BLVD STE 8",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409067361",
            "telephone_number": "606-277-0173",
            "fax_number": "606-277-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 TREUHAFT BLVD STE 8",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409067361",
            "telephone_number": "606-277-0173",
            "fax_number": "606-277-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "HEATHER",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3015202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barbourville, KY

Sources for this page

Verify at the official NPI Registry.