Individual provider Active NPI

Carly Louderback Davis, FNP-C

  • Family Nurse Practitioner
  • Ringgold, GA
National Provider Identifier
1265910475
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F07180027 Issued in GA
Practice address
210 Gilbert Rd
Ringgold, GA 30736-2724
Phone
(423) 715-0867
NPI assigned
Jul 31, 2018
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN277403 GA
Family Nurse Practitioner 363LF0000X F07180027 GA Primary

Addresses

Primary practice location

210 Gilbert Rd
Ringgold, GA 30736-2724

Mailing address

210 Gilbert Rd
Ringgold, GA 30736-2724
Phone (423) 715-0867

Other names 1

  • Carly Megan Louderback Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20190108003462 GA Practitioner - Nurse Practitioner 8325384589 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN277403GAMDRegistered Nurse
F07180027GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Whitfield County Board of Health CurrentSince Nov 19, 2018 Accepting new patients

Locations

800 Professional Blvd
Dalton, GA 30720
Phone (706) 226-5446

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": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1265910475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 GILBERT RD",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307362724",
            "telephone_number": "423-715-0867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 GILBERT RD",
            "city": "RINGGOLD",
            "state": "GA",
            "postal_code": "307362724",
            "telephone_number": "423-715-0867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CARLY",
        "middle_name": "LOUDERBACK",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN277403",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F07180027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "LOUDERBACK",
            "middle_name": "MEGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ringgold, GA

Sources for this page

Verify at the official NPI Registry.