Individual provider Active NPI

Andrew C.F. Davis-Cole, FNP

  • Adult Health Nurse Practitioner
  • Poplar Bluff, MO
National Provider Identifier
1205852282
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2019034475 Issued in MO
Practice address
2865 James Blvd
Poplar Bluff, MO 63901-2803
Phone
(573) 776-1100
Fax
(573) 776-1107
NPI assigned
Jul 14, 2006
Last updated
Jan 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2019034475 MO Primary
Family Nurse Practitioner 363LF0000X 2001002272 MO
Family Nurse Practitioner 363LF0000X APN0000005959 TN
Registered Nurse 163W00000X UPN-5959 TN
Registered Nurse 163W00000X RN000066878 TN

Addresses

Primary practice location

2865 James Blvd
Poplar Bluff, MO 63901-2803

Mailing address

1226 Linn St
Suite F
Sikeston, MO 63801-5200
Phone (573) 481-0700

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN000066878TNMDRegistered Nurse
UPN-5959TNMDRegistered Nurse
2019034475MOMDAdult Health Nurse Practitioner
APN0000005959TNMDFamily Nurse Practitioner

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11992/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1205852282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 LINN ST",
            "address_2": "SUITE F",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015200",
            "telephone_number": "573-481-0700",
            "fax_number": "573-481-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 JAMES BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012803",
            "telephone_number": "573-776-1100",
            "fax_number": "573-776-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-COLE",
        "first_name": "ANDREW",
        "middle_name": "C.F.",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2019034475",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2001002272",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000005959",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "UPN-5959",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN000066878",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.