Renee L Davis, DNP, APRN, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

209-005885 Issued in IL

Practice address

3030 Frank Scott Parkway West
Suite 1
Belleville, IL 62223-5014

Phone

(618) 257-2550

Fax

(618) 257-2569

NPI assigned

Apr 30, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• David C. Norman MD Inc

  • Pediatric Adolescent Medicine Physician
  • Belleville, IL
  • NPI 1841475746
  NPD (past)

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1265608251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 FRANK SCOTT PARKWAY WEST",
            "address_2": "SUITE 1",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235014",
            "telephone_number": "618-257-2550",
            "fax_number": "618-257-2569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 FRANK SCOTT PARKWAY WEST",
            "address_2": "SUITE 1",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235014",
            "telephone_number": "618-257-2550",
            "fax_number": "618-257-2569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RENEE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "DNP, APRN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-30",
        "last_updated": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "036090116",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209-005885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209-005885",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036090116",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candyce D Davis
• Elissa Davis, M.D.
• Ellisha Davis
• Erica Renee Davis, NP
• Kimberly Dawn Davis, FNP
• Renisha Lashay Davis, LSW
• Sara Davis, MSW
• Timur Davydov, DPM
• Dawn M Robinson Chiropractic SC
• Paula J Dawson, CRNA

• Pediatric Nurse Practitioner in Belleville, IL
• Providers in Belleville, IL by specialty
• Pediatric Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.