Individual provider Active NPI

Ashley Waite Davis, FNP-C

  • Family Nurse Practitioner
  • Greenville, NC
National Provider Identifier
1215363528
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5006744 Issued in NC
Practice address
2455 Emerald PL
Greenville, NC 27834-5785
Phone
(252) 758-2224
Fax
(252) 413-0857
NPI assigned
Sep 18, 2013
Last updated
Jun 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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 5006744 NC Primary

Addresses

Primary practice location

2455 Emerald PL
Greenville, NC 27834-5785

Mailing address

1434 Boyd Galloway Rd
Grimesland, NC 27837-9071
Phone (607) 742-8038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20141029000167 NC Practitioner - Nurse Practitioner 8820219215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Surgical Associates PAGroup PAC ID 4183654163, 3 clinicians

Practice addresses (Care Compare)

2455 Emerald PL
Greenville, NC 27834-5785
Phone (252) 758-2224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5006744NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Surgical Associates, PA CurrentSince Feb 7, 2024 Accepting new patients

Locations

2455 Emerald Pl
Greenville, NC 27834
Phone (252) 758-2224

Interoperability endpoints

  • Direct secure messaging: ashley.davis.1@8736.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8736/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1215363528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1434 BOYD GALLOWAY RD",
            "city": "GRIMESLAND",
            "state": "NC",
            "postal_code": "278379071",
            "telephone_number": "607-742-8038",
            "fax_number": "252-413-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 EMERALD PL",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345785",
            "telephone_number": "252-758-2224",
            "fax_number": "252-413-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ASHLEY",
        "middle_name": "WAITE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-18",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5006744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.