Active NPI
Jean Davis, ARNP
- Nurse Practitioner
- Hollywood, FL
National Provider Identifier
1336342922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- ARNP 2709652
- Practice address
- 3600 Washington St
Hollywood, FL 33021-8216 - Phone
- (954) 518-5350
- NPI assigned
- Jun 9, 2007
- Last updated
- Sep 9, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP 2709652 | FL | Primary |
Addresses
Primary practice location
3600 Washington St
Hollywood, FL 33021-8216
Mailing address
3600 Washington St
MRH-South
Hollywood, FL 33021-8216
Phone (954) 518-5350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP 2709652 | FL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220918400000",
"number": "1336342922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 WASHINGTON ST",
"address_2": "MRH-SOUTH",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330218216",
"telephone_number": "954-518-5350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 WASHINGTON ST",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330218216",
"telephone_number": "954-518-5350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JEAN",
"name_prefix": "Dr.",
"credential": "ARNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-09",
"last_updated": "2008-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP 2709652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.