Individual provider Active NPI

Jennifer L Davis, ARNP-C

  • Adult Health Nurse Practitioner
  • Orlando, FL
National Provider Identifier
1124144993
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP3090432 Issued in FL
Practice address
3464 Avalon Park East Blvd
Orlando, FL 32828-7363
Phone
(407) 302-3115
Fax
(321) 203-4602
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X ARNP3090432 FL
Adult Health Nurse Practitioner 363LA2200X ARNP3090432 FL Primary

Addresses

Primary practice location

3464 Avalon Park East Blvd
Orlando, FL 32828-7363

Mailing address

3464 Avalon Park East Blvd
Orlando, FL 32828-7363
Phone (407) 302-3115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20111116000834 FL Practitioner - Nurse Practitioner 6305010919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orlando Physicians Network IncGroup PAC ID 7719026251, 231 clinicians

Practice addresses (Care Compare)

21 Columbia St
Orlando, FL 32806-1133
Phone (321) 841-6600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Orlando Physicians Network Inc CurrentSince Apr 22, 2020 Accepting new patients
Orlando Health Medical Group Inc Past Accepting new patients

Locations

725 Rodel Cv
Lake Mary, FL 32746
Phone (407) 302-3130

719 Rodel Cv
Ste 2001
Lake Mary, FL 32746
Phone (407) 302-3106

3464 E Avalon Park Blvd
Orlando, FL 32828
Phone (407) 635-3020

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

Interoperability endpoints

  • Direct secure messaging: jdavis27929@orlandohealth.medalliesdirect.net

Organizations & group practices 3

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1124144993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3464 AVALON PARK EAST BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287363",
            "telephone_number": "407-302-3115",
            "fax_number": "321-203-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3464 AVALON PARK EAST BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287363",
            "telephone_number": "407-302-3115",
            "fax_number": "321-203-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "FL",
            "license": "ARNP3090432",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP3090432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.