Individual provider Active NPI

Joni Davis, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1154726834
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18715 Issued in TN
Practice address
289 Vann Dr Ste a
Jackson, TN 38305-6050
Phone
(731) 410-6786
NPI assigned
Oct 24, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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 18715 TN Primary

Addresses

Primary practice location

289 Vann Dr Ste a
Jackson, TN 38305-6050

Mailing address

289 Vann Dr Ste a
Jackson, TN 38305-6050
Phone (731) 410-6786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20150304002328 TN Practitioner - Nurse Practitioner 3274859509 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18715TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 1, 2014 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Dec 1, 2014 Accepting new patients
Goodwin Childrens Clinic, PLC Past Accepting new patients

Locations

125 W Church St
Lexington, TN 38351
Phone (731) 249-9300

1860 Wayne Rd
Savannah, TN 38372
Phone (731) 926-4222

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIDECD/Endpoint/DIDECD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414108800000",
    "number": "1154726834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 VANN DR STE A",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383056050",
            "telephone_number": "731-410-6786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 VANN DR STE A",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383056050",
            "telephone_number": "731-410-6786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JONI",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.