Maxine Reeves Davis

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

9392831 Issued in FL

Practice address

96 SW Allapattah Rd
Indiantown, FL 34956-4307

Phone

(772) 597-9441

NPI assigned

Apr 13, 2022

Last updated

Sep 7, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Balanced Wellbeing LLC

  • Psychiatry Physician
  • Ocala, FL
  • NPI 1336513639

  Single Specialty

  Medicare reassignment NPD
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000

  Single Specialty

  Medicare reassignment NPD
• Mind-Fully-Yours Recovery & Wellness

  • Psychiatric/Mental Health Registered Nurse
  • Port St Lucie, FL
  • NPI 1023844255

  Single Specialty

  NPD Authorized official
• MCR Health, Inc.

  dba Riverside Medical Center

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1295478733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 SW COLLEGE PARK RD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349535869",
            "telephone_number": "305-336-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 SW ALLAPATTAH RD",
            "city": "INDIANTOWN",
            "state": "FL",
            "postal_code": "349564307",
            "telephone_number": "772-597-9441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 N 12th Ave Bldg B",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "FL",
            "postal_code": "342668752",
            "country_code": "US",
            "telephone_number": "863-494-1242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REEVES DAVIS",
        "first_name": "MAXINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9392831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia B. Pajares, LCSW
• John Pasquale, OTR/L
• Tisha Alecia Patten, NP-C, ARNP
• Physical Therapy Internet P.a. (Physical Therapy of Indiantown)
• Kimberli Vonkey Pittman
• Hazel Lizeth Romero, MD
• Brian Boyd Rucks
• Patricia Del Carmen Ruiz de Nunez, DMD
• Leah Dawn Scott, MSW
• Amarilis Sena

• Psychiatric/Mental Health Nurse Practitioner in Indiantown, FL
• Providers in Indiantown, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.