Georgia D Davault, ARNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

1070882 Issued in FL

Practice address

14271 Metropolis Ave
Suite a
Fort Myers, FL 33912-4302

Phone

(239) 939-7777

Fax

(239) 936-0036

NPI assigned

Nov 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Neuropsychiatric Research Center of Southwest Florida LLC

  • Psychiatry Physician
  • Fort Myers, FL
  • NPI 1013118041
  NPD (past)

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227571200000",
    "number": "1235384694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5651 LOCHNESS CT",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339034928",
            "telephone_number": "239-997-7019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14271 METROPOLIS AVE",
            "address_2": "SUITE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124302",
            "telephone_number": "239-939-7777",
            "fax_number": "239-936-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVAULT",
        "first_name": "GEORGIA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-25",
        "last_updated": "2008-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "1070882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vijay Das, MD
• Nice Daswani, LMHC
• Julie A Daubenspeck, LMFT
• Richard Michael Daum, MD
• Ana Davalos
• Jamie Davenport, DMD
• Cynthia S Davey, PH.D. CLINICAL PSYCH
• David Austin Cale Elkin LLC
• David K. Taylor, Chiropractor, Inc
• David M Martinez

• Adult Health Nurse Practitioner in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.