Individual provider Active NPI

Vanessa Ann Davis, FNP

  • Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1104879329
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN7987 Issued in TN
Practice address
5818 Winchester Rd
Memphis, TN 38115-4711
Phone
(901) 590-2202
Fax
(901) 433-9326
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A810172 MS
Nurse Practitioner 363L00000X APN7987 TN Primary

Addresses

Primary practice location

5818 Winchester Rd
Memphis, TN 38115-4711

Mailing address

2809 Kirby Rd Ste 116
Memphis, TN 38119-8245
Phone (901) 590-2202

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://healow.com/apps/provider/vanessa-davis-2360528 Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20090413000306 TN Practitioner - Nurse Practitioner 4385719467 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN7987TNMDNurse Practitioner

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1104879329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 KIRBY RD STE 116",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381198245",
            "telephone_number": "901-590-2202",
            "fax_number": "901-433-9326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5818 WINCHESTER RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381154711",
            "telephone_number": "901-590-2202",
            "fax_number": "901-433-9326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "VANESSA",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "A810172",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN7987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://healow.com/apps/provider/vanessa-davis-2360528",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5818 Winchester Rd",
            "city": "Memphis",
            "state": "TN",
            "country_code": "US",
            "postal_code": "381154711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.