Active NPI
Emily Davis
- Registered Nurse
- Poplar Bluff, MO
National Provider Identifier
1225759533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 2018022988
- Practice address
- 2981 Kanell Blvd
Poplar Bluff, MO 63901-4008 - Phone
- (573) 776-1941
- NPI assigned
- Sep 6, 2022
- 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 | 2018022988 | MO | Primary |
Addresses
Primary practice location
2981 Kanell Blvd
Poplar Bluff, MO 63901-4008
Mailing address
1601 Old South River Rd
Saint Charles, MO 63303-4120
Phone (636) 224-1210
Other names 1
- Emily Duckett
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 |
|---|---|---|---|
| 2018022988 | MO | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662422400000",
"number": "1225759533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 OLD SOUTH RIVER RD",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633034120",
"telephone_number": "636-224-1210",
"fax_number": "636-246-1008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2981 KANELL BLVD",
"city": "POPLAR BLUFF",
"state": "MO",
"postal_code": "639014008",
"telephone_number": "573-776-1941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-06",
"last_updated": "2022-09-06",
"certification_date": "2022-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MO",
"license": "2018022988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EMILY",
"last_name": "DUCKETT",
"code": "1",
"type": "Former Name"
}
]
}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 Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.