Individual provider Active NPI

Cinthia L Davis, NP

  • Adult Health Nurse Practitioner
  • Pontiac, MI
National Provider Identifier
1184885584
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704166565 Issued in MI
Practice address
55 Clinton St
Pontiac, MI 48342-2177
Phone
(248) 333-0840
Fax
(248) 333-0978
NPI assigned
Jun 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 4704166565 MI Primary

Addresses

Primary practice location

55 Clinton St
Pontiac, MI 48342-2177

Mailing address

55 Clinton St
Pontiac, MI 48342-2177
Phone (248) 333-0840

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704166565MIMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
SJMH Medical Practice-SMHC Past Accepting new patients
SJMH Medical Practice-SMHC Past Accepting new patients

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": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1184885584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CLINTON ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422177",
            "telephone_number": "248-333-0840",
            "fax_number": "248-333-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CLINTON ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422177",
            "telephone_number": "248-333-0840",
            "fax_number": "248-333-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CINTHIA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704166565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.