Active NPI
Hattie McLane Davis, BSN RN
- Critical Care Medicine Registered Nurse
- Charleston, WV
National Provider Identifier
1124819040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- 109766
- Practice address
- 4605 Maccorkle Ave SW
Charleston, WV 25309-1311 - Phone
- (304) 766-3600
- NPI assigned
- May 13, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 109766 | WV | Primary |
Addresses
Primary practice location
4605 Maccorkle Ave SW
Charleston, WV 25309-1311
Mailing address
465 Silver Maple RDG Apt 9
Charleston, WV 25306-1153
Phone (304) 932-7576
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
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109766 | WV | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747094400000",
"number": "1124819040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "465 SILVER MAPLE RDG APT 9",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253061153",
"telephone_number": "304-932-7576",
"fax_number": "304-932-7576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4605 MACCORKLE AVE SW",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253091311",
"telephone_number": "304-766-3600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "HATTIE",
"middle_name": "MCLANE",
"credential": "BSN RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-13",
"last_updated": "2025-05-13",
"certification_date": "2025-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "WV",
"license": "109766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.