Davis Health & Wellness Clinic, P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

DAVIS HEALTH & WELLNESS CLINIC, P.C.

Practice address

808 Speciality Dr Ste a
Dexter, MO 63841-2753

Phone

(573) 891-1250

Fax

(573) 891-1320

NPI assigned

Apr 29, 2022

Last updated

Apr 29, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bradford Joseph Davis, FNP-BCNPI 1184002842

Title

Owner/Provider

Phone

(573) 891-1250

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradford Joseph Davis, FNP-BC

  • Family Nurse Practitioner
  • Dexter, MO
  • NPI 1184002842
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651190400000",
    "number": "1154066561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638410603",
            "telephone_number": "573-891-1250",
            "fax_number": "573-891-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 SPECIALITY DR STE A",
            "city": "DEXTER",
            "state": "MO",
            "postal_code": "638412753",
            "telephone_number": "573-891-1250",
            "fax_number": "573-891-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS HEALTH & WELLNESS CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "573-891-1250",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Lynn Conde, RN
• Brendan Robert Crader
• Martha Crawford, R.N,
• D&S Drug LLC
• D&S Drug LLC
• Bradford Joseph Davis, FNP-BC
• Savannah Joy Deane, FNP-C
• Demaree Mitchell Family Dentistry LLC
• Derek Demaree, PHD
• Terry W Demaree, DDS

• Primary Care Clinic/Center in Dexter, MO
• Providers in Dexter, MO by specialty
• Primary Care Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.