Individual provider Active NPI

Dana Arender Davis, FNP-C

  • Family Nurse Practitioner
  • Jackson, MS
National Provider Identifier
1134966344
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906728 Issued in MS
Practice address
1200 N State St Ste 130
Jackson, MS 39202-2027
Phone
(601) 841-3223
Fax
(601) 841-3172
NPI assigned
Jul 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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 906728 MS Primary

Addresses

Primary practice location

1200 N State St Ste 130
Jackson, MS 39202-2027

Mailing address

101 Webster Cir Ste 300
Madison, MS 39110-7789
Phone (601) 348-8988

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

State licenses

LicenseStateTypeSpecialty
906728MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Caloss Center for Facial Reconstruction PLLC CurrentSince Jul 21, 2024 Accepting new patients
Mississippi Medical Group, Inc CurrentSince Sep 23, 2024 Accepting new patients

Locations

1200 N State St
Ste 130
Jackson, MS 39202
Phone (601) 841-3223

101 Webster Cir
Ste 300
Madison, MS 39110
Phone (601) 573-2294

Organizations & group practices 2

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": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1134966344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WEBSTER CIR STE 300",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107789",
            "telephone_number": "601-348-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST STE 130",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392022027",
            "telephone_number": "601-841-3223",
            "fax_number": "601-841-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DANA",
        "middle_name": "ARENDER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.