Rebecca Caroline Davis, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN255236 Issued in GA

Practice address

1121 Johnson Ferry Rd Ste 320
Marietta, GA 30068-5404

Phone

(770) 509-0017

Fax

(770) 971-7818

NPI assigned

Jan 10, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Rebecca Caroline Burnette Former name

Electronic endpoints 2

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

Specialty

Nurse Practitioner

Education

Vanderbilt University School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Primary Care Professional Services,LLCGroup PAC ID 9638343924, 313 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ecfm@northside.gwaydirect.com
• Direct secure messaging: rebecca.davis@northsidehospital.cernerdirect.com

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.

• Northside Primary Care Professional Services,LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1922397553
  Medicare reassignment Care Compare group NPD
• Northside Primary Care Professional Services, LLC

  • Urgent Care Clinic/Center
  • Dawsonville, GA
  • NPI 1215369715
  NPD
• Emory Specialty Associates, LLC

  • Anesthesiology Physician
  • Lagrange, GA
  • NPI 1407864168
  NPD (past)
• The Emory Clinic Pediatric Providers

  • Pediatric Surgery Physician
  • Decatur, GA
  • NPI 1720285653
  NPD (past)
• Aiken Emergency Physicians

  • Primary Care Nurse Practitioner
  • Aiken, SC
  • NPI 1205622362
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1285904052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300848100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 JOHNSON FERRY RD STE 320",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300685404",
            "telephone_number": "770-509-0017",
            "fax_number": "770-971-7818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "REBECCA",
        "middle_name": "CAROLINE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000016131",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19060",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN255236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rebecca.davis@northsidehospital.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "1121 Johnson Ferry Rd Ste 320",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300685404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ECFM@Northside.gwaydirect.com",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "1121 Johnson Ferry Rd Ste 320",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300685404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "BURNETTE",
            "middle_name": "CAROLINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Lee Davis, MS, RD, LD
• Linda S Davis, NP
• Michael Tyler Davis, PT
• Monique A Davis, LMSW
• Davis, Paquette, and Molineaux Holdings, LLC
• Robert Scott Davis, PSY.D.
• Shelby Alexis Davis, LPC
• Shellie R Davis, CCC-SLP
• Thaddeus Davis
• Trevor Davis

• Family Nurse Practitioner in Marietta, GA
• Providers in Marietta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.