Christopher Wayne Davis, NP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

AP122022 Issued in TX

Practice address

4560 Lake Ridge Pkwy Ste 110
Grand Prairie, TX 75052-1707

Phone

(972) 522-7778

Fax

(972) 522-7779

NPI assigned

Feb 28, 2012

Last updated

May 21, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Physician Resources, LLPGroup PAC ID 7012161375, 91 clinicians

MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cdavis54910@dm.mhd.com

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.

• Medhealth

  dba Methodist Medical Group

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1912957200
  Medicare reassignment Care Compare group NPD
• Texas Physician Resources, LLP

  • Emergency Medicine Physician
  • Fort Worth, TX
  • NPI 1639413289
  Medicare reassignment Care Compare group NPD
• Regional Employee Assistance Program Inc

  • Family Medicine Physician
  • Corsicana, TX
  • NPI 1649232984
  Medicare reassignment NPD
• Medhealth

  dba Methodist Medical Group

  • Urgent Care Clinic/Center
  • Grand Prairie, TX
  • NPI 1558762690
  NPD
• Regional Employee Assistance Program Inc

  • Cardiovascular Disease Physician
  • Abilene, TX
  • NPI 1073575585
  NPD
• Regional Employee Assistance Program Inc

  • Family Medicine Physician
  • San Angelo, TX
  • NPI 1124080320
  NPD
• Regional Employee Assistance Program Inc

  • General Practice Physician
  • San Angelo, TX
  • NPI 1750302923
  NPD (past)

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

{
    "created_epoch": "1330387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590019200000",
    "number": "1326312026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 LAKE RIDGE PKWY STE 110",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521707",
            "telephone_number": "972-522-7778",
            "fax_number": "972-522-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 LAKE RIDGE PKWY STE 110",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521707",
            "telephone_number": "972-522-7778",
            "fax_number": "972-522-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHRISTOPHER",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-28",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP122022",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "777567",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David Grice DO PA
• Cathina Davis
• Kenneth Samuel Dawes Jr., PT, DPT
• Daybreak, Inc. (Amicus at Woodside)
• De Amazing Grace LLC
• De Lovely Home Care Inc.
• Niyomi De Silva, M.D.

• Primary Care Nurse Practitioner in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.