Individual provider Active NPI

Tessa Abraham Davis-Walz, FNP

  • Family Nurse Practitioner
  • Iowa City, IA
National Provider Identifier
1356911630
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A178626 Issued in IA
Practice address
200 Hawkins Dr
Iowa City, IA 52242-1009
Phone
(319) 356-3457
Fax
(319) 356-3392
NPI assigned
Jun 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN.0996585-NP CO
Family Nurse Practitioner 363LF0000X APN.0996585-NP CO
Family Nurse Practitioner 363LF0000X A178626 IA Primary

Addresses

Primary practice location

200 Hawkins Dr
Iowa City, IA 52242-1009

Mailing address

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-3457

Other practice location 1

6041 S Syracuse Way Ste 220
Greenwood Village, CO 80111-4716
Phone (720) 482-1988

Other practice location 2

1750 E Ken Pratt Blvd
Longmont, CO 80504-5311
Phone (720) 718-2002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210723001183 CO Practitioner - Nurse Practitioner 7214330570 Reassigns benefits to 1 organization
I20240731001297 IA Practitioner - Nurse Practitioner 7214330570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State University of IowaGroup PAC ID 7618884230, 1,886 clinicians

Practice addresses (Care Compare)

200 Hawkins Dr
Iowa City, IA 52242-1009
Phone (319) 356-1616

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State University of Iowa CurrentSince Jul 22, 2024 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Jun 13, 2022 Accepting new patients
Artemis Healthcare Services LLC CurrentSince Jul 26, 2021 Accepting new patients
Poudre Valley Medical Group, LLC Current Accepting new patients
State University of Iowa Past Accepting new patients
Agape Palliative Services, LLC PastSince Jul 1, 2021 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

6041 S Syracuse Way
Ste 220
Greenwood Village, CO 80111
Phone (720) 482-1988

1750 E Ken Pratt Blvd
Longmont, CO 80504
Phone (720) 718-7000

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

200 Hawkins Dr
#H
Iowa City, IA 52242
Phone (319) 356-1616

200 Hawkins Dr
Iowa City, IA 52242
Phone (319) 356-1616

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1356911630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-3457",
            "fax_number": "319-356-3392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421009",
            "telephone_number": "319-356-3457",
            "fax_number": "319-356-3392"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6041 S Syracuse Way Ste 220",
            "address_purpose": "LOCATION",
            "city": "Greenwood Village",
            "state": "CO",
            "postal_code": "801114716",
            "country_code": "US",
            "telephone_number": "720-482-1988",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1750 E Ken Pratt Blvd",
            "address_purpose": "LOCATION",
            "city": "Longmont",
            "state": "CO",
            "postal_code": "805045311",
            "country_code": "US",
            "telephone_number": "720-718-2002",
            "fax_number": "720-718-0914",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS-WALZ",
        "first_name": "TESSA",
        "middle_name": "ABRAHAM",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0996585-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0996585-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A178626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.