Timothy C Davis, RN,PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

582080 Issued in TX

Practice address

104 S Park Dr
Brownwood, TX 76801-5918

Phone

(325) 646-0704

Fax

(325) 646-1513

NPI assigned

Aug 20, 2006

Last updated

Nov 28, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tdavis22508@direct.phhs.org

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.

• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment NPD
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Pediatrics Physician
  • Dallas, TX
  • NPI 1750351375

  Pediatrics, Critical Care

  NPD

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1326153198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 BARBERRY DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752111805",
            "telephone_number": "214-529-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S PARK DR",
            "city": "BROWNWOOD",
            "state": "TX",
            "postal_code": "768015918",
            "telephone_number": "325-646-0704",
            "fax_number": "325-646-1513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TIMOTHY",
        "middle_name": "C",
        "credential": "RN,PNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "582080",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "TX",
            "license": "582080",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "582080",
            "primary": true
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "TX",
            "license": "582080",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1742694",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Curry, M.D.
• David George Curtis, MD
• CVS Pharmacy Inc (CVS Pharmacy #07269)
• Dan Stewart M.D., PA
• Lisa Marlene Darley
• Haley Shannon Day, CRNA
• James Deal
• Debbie Crawford DO and Associates (Brownwood Family Practice)
• Raquel R Delgado, LMT, MMP
• Dennis W Helbert (Live Oak Pharmacy)

• Pediatric Nurse Practitioner in Brownwood, TX
• Providers in Brownwood, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.