Individual provider Active NPI

Lucretia Davis

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1285269241
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3014452 Issued in KY
Practice address
2406 W Broadway
Louisville, KY 40211-1008
Phone
(502) 775-1211
NPI assigned
Mar 10, 2020
Last updated
Oct 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3014452 KY Primary

Addresses

Primary practice location

2406 W Broadway
Louisville, KY 40211-1008

Mailing address

2406 W Broadway
Louisville, KY 40211-1008
Phone (502) 775-1211

Other identifiers 1

IdentifierTypeStateIssuer
RN1123437OtherKYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200402001622 KY Practitioner - Nurse Practitioner 6002245602 Reassigns benefits to 5 organizations
I20250402003000 IN Practitioner - Nurse Practitioner 6002245602 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Green Valley Hospital Medicine Physicians, LLC CurrentSince Nov 1, 2025 Accepting new patients
New Albany Hospitalist Group, LLC CurrentSince Mar 19, 2025 Accepting new patients
Pinnacle Inpatient Medical Services, PLLC CurrentSince Jan 25, 2025 Accepting new patients
SHC Medical Partners of Kentucky, LLC CurrentSince Feb 19, 2020 Accepting new patients
Lu Legacy Homecare Limited Liability Company Current Accepting new patients
PMR Ky Holding, LLC CurrentSince Oct 1, 2025 Accepting new patients
Amin's Family Practice Associates , PSC Family CurrentSince Sep 12, 2023 Accepting new patients

Locations

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

3300 Tates Creek Rd
Lexington, KY 40502
Phone (859) 266-2126

10100 Dixie Hwy
Louisville, KY 40272
Phone (502) 637-1005

12201 Bluegrass Pkwy
Louisville, KY 40299
Phone (502) 568-7364

1405 Browns Ln
Louisville, KY 40207
Phone (502) 896-0495

1505 S 7th St
Louisville, KY 40208
Phone (502) 637-1005

2406 W Broadway
Louisville, KY 40211
Phone (502) 775-1211

2529 Six Mile Ln
Louisville, KY 40220
Phone (502) 491-5560

7926 Preston Hwy
Ste 103
Louisville, KY 40219
Phone (502) 309-9811

805 N Whittington Pkwy
Northfield, KY 40222
Phone (502) 627-7000

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

3909 S Wilson Rd
Radcliff, KY 40160
Phone (270) 351-8976

625 Taylorsville Rd
Taylorsville, KY 40071
Phone (423) 581-8844

Organizations & group practices 7

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": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1285269241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111008",
            "telephone_number": "502-775-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2406 W BROADWAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111008",
            "telephone_number": "502-775-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LUCRETIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-10",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3014452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN1123437",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.