Shenandoah Davis, AGNP-C
Individual provider Active NPI Adult Health Nurse Practitioner · Henderson, TX
NPI 1295599363 · NPPES record last updated Feb 9, 2024
Key facts
- NPI
- 1295599363
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 1152445 (TX)
- Practice address
- 1615 McAllen St
Henderson, TX 75654-4273 - Phone
- (903) 658-6398
- NPI assigned
- Feb 9, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Segue Health of Texas PLLC
Practice addresses (Care Compare)
6815 Hill CT
Azle, TX 76020-5513
Phone 8885512538101
Hospital & facility affiliations
- Accentcare Home Health of Texas
- Christus Good Shepherd
- Ut Health East Texas Carthage Hospital
- Christus Good Shepherd Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240426002380 | TX | Practitioner - Nurse Practitioner | 1355781170 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1152445 | TX | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Segue Health of Texas PLLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 1152445 | TX | |
| Adult Health Nurse Practitioner | 363LA2200X | 1152445 | TX | Yes |
Addresses
Primary practice location
1615 McAllen St
Henderson, TX 75654-4273
Mailing address
1615 McAllen St
Henderson, TX 75654-4273
Phone (903) 658-6398
Other names
- Mrs. Shenandoah Davis
Other providers in Henderson, TX
- Christopher Cummings
- CVS Pharmacy Inc
- D&S Residential Services, LP
- Michelle Sarenia Daley
- Glena June Davis
- Heather Anne Dean
- Amsale Derese
- Dogwood Orthopaedic Clinic, PA
- John Lynn Duran
- East Texas Learning Lab
All providers in Henderson, TX · Adult Health Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.