Individual provider Active NPI

David Benjamin Davis III, RN, MSN, MHS, FNP

  • Family Nurse Practitioner
  • Santa Cruz, CA
National Provider Identifier
1124818083
Registry record updated Dec 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95036726 Issued in CA
Practice address
1080 Emeline Ave
Santa Cruz, CA 95060-1966
Phone
(831) 345-3266
NPI assigned
May 12, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95036726 CA Primary
General Practice Registered Nurse 163WG0000X 552048 CA

Addresses

Primary practice location

1080 Emeline Ave
Santa Cruz, CA 95060-1966

Mailing address

2956 Rossmore CT
San Jose, CA 95148-3524
Phone (650) 743-2611

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)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
552048CAMDGeneral Practice Registered Nurse
95036726CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765065600000",
    "number": "1124818083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2956 ROSSMORE CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951483524",
            "telephone_number": "650-743-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 EMELINE AVE",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950601966",
            "telephone_number": "831-345-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DAVID",
        "middle_name": "BENJAMIN",
        "name_suffix": "III",
        "credential": "RN, MSN, MHS, FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-12-07",
        "certification_date": "2025-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95036726",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "552048",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2025; 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.