Whitney Diane Davis, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA0000002497 Issued in TN

Practice address

2514 Wesley St Ste 102
Johnson City, TN 37601-1764

Phone

(423) 282-2700

Fax

(423) 282-2802

NPI assigned

Dec 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Whitney D. Bartlett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15857/brand/1/csg/1/fhir/r4

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.

• Extended Care Physicians - Piedmont, PA

  • Geriatric Medicine (Family Medicine) Physician
  • Hickory, NC
  • NPI 1417013988
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1265594618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 WESLEY ST STE 102",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011764",
            "telephone_number": "423-282-2700",
            "fax_number": "423-282-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 WESLEY ST STE 102",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011764",
            "telephone_number": "423-282-2700",
            "fax_number": "423-282-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WHITNEY",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA0000002497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC PA LICENSE INACTIVE",
            "identifier": "0010-00630",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265594618",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WHITNEY",
            "last_name": "BARTLETT",
            "middle_name": "D.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pamela B Davis, PA-C
• Penny Elaine Davis, BSW
• Rachael Davis
• Shaylie Davis, APRN
• Tyler Davis, DDS
• Dawn of Hope, Inc
• Dawn of Hope, Inc.
• Sarah Dawson-Moroz, MPH
• Judith L Day, FNP
• Miranda Day, NP

• Physician Assistant in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.