Active NPI
Patricia JN Davis, FNP-C
- Family Nurse Practitioner
- Massillon, OH
National Provider Identifier
1356994685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 0027444
- Practice address
- 1660 Nave Rd SE
Massillon, OH 44646-9604 - Phone
- (330) 455-0374
- Fax
- (330) 453-6716
- NPI assigned
- Jul 16, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN.430577 | OH | |
| Family Nurse Practitioner | 363LF0000X | 0027444 | OH | Primary |
Addresses
Primary practice location
1660 Nave Rd SE
Massillon, OH 44646-9604
Mailing address
625 Cleveland Ave NW
Canton, OH 44702-1805
Phone (330) 455-0374
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN.430577 | Other | OH | BOARD OF NURSING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN.430577 | OH | MD | Registered Nurse |
| 0027444 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oh Independent Medical Group LLC | Current | Accepting new patients | |
| Oh Independent Medical Group LLC | Current | Accepting new patients | |
| Paragon Heart Group, Inc | Past | Accepting new patients |
Locations
4465 Fulton Dr NW
Ste 100
Canton, OH 44718
Phone (330) 497-2700
7450 Hospital Dr
Ste 4500
Dublin, OH 43016
Phone (614) 566-0166
444 N Cleveland Ave
Ste 120
Westerville, OH 43082
Phone (614) 818-0300
Interoperability endpoints
- patricia.davis.1@26020.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Columbus, OH
- NPI 1497482111
-
- Family Medicine Physician
- Akron, OH
- NPI 1205845500
-
- Durable Medical Equipment & Medical Supplies
- Circleville, OH
- NPI 1114753431
-
- Cardiovascular Disease Physician
- Alliance, OH
- NPI 1932372398
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600300800000",
"number": "1356994685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 CLEVELAND AVE NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447021805",
"telephone_number": "330-455-0374",
"fax_number": "330-453-6716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 NAVE RD SE",
"city": "MASSILLON",
"state": "OH",
"postal_code": "446469604",
"telephone_number": "330-455-0374",
"fax_number": "330-453-6716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "PATRICIA",
"middle_name": "JN",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-16",
"last_updated": "2020-09-17",
"certification_date": "2020-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN.430577",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "0027444",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF NURSING",
"identifier": "RN.430577",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Massillon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.