Active NPI
Rich Davis, L.V.N
- Licensed Vocational Nurse
- Sacramento, CA
National Provider Identifier
1295951887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- VN171232
- Practice address
- 2571 Fulton Square LN
# 64
Sacramento, CA 95821-2382 - Phone
- (916) 972-9922
- NPI assigned
- Apr 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | VN171232 | CA | Primary |
Addresses
Primary practice location
2571 Fulton Square LN
# 64
Sacramento, CA 95821-2382
Mailing address
2571 Fulton Square LN
# 64
Sacramento, CA 95821-2382
Phone (916) 972-9922
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PAO860 | Other | CA | ALTA REGIONAL VENDOR # |
| EPS013620 | Other | CA | MEDI-CAL PED PROVIDER # |
| RVN002000 | Other | CA | MEDI-CAL ADULT PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VN171232 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264723200000",
"number": "1295951887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2571 FULTON SQUARE LN",
"address_2": "# 64",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958212382",
"telephone_number": "916-972-9922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2571 FULTON SQUARE LN",
"address_2": "# 64",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958212382",
"telephone_number": "916-972-9922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "RICH",
"name_prefix": "Mr.",
"credential": "L.V.N",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-18",
"last_updated": "2010-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "VN171232",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTA REGIONAL VENDOR #",
"identifier": "PAO860",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL PED PROVIDER #",
"identifier": "EPS013620",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL ADULT PROVIDER",
"identifier": "RVN002000",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.