Active NPI
Jessica Antoinette Davis, REGISTERED NURSE
- Registered Nurse
- Camp Lejeune, NC
National Provider Identifier
1164836359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 0001217667
- Practice address
- 100 Brewster Blvd
Camp Lejeune, NC 28547-2538 - Phone
- (910) 450-4300
- NPI assigned
- Jun 16, 2014
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0001217667 | VA | Primary |
Addresses
Primary practice location
100 Brewster Blvd
Camp Lejeune, NC 28547-2538
Mailing address
503 Sonoma Rd
Jacksonville, NC 28546-8446
Phone (843) 338-0800
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0001217667 | VA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431648000000",
"number": "1164836359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "503 SONOMA RD",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285468446",
"telephone_number": "843-338-0800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 BREWSTER BLVD",
"city": "CAMP LEJEUNE",
"state": "NC",
"postal_code": "285472538",
"telephone_number": "910-450-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JESSICA",
"middle_name": "ANTOINETTE",
"name_prefix": "Mrs.",
"credential": "REGISTERED NURSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-16",
"last_updated": "2015-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "VA",
"license": "0001217667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camp Lejeune, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.