Individual provider Active NPI

Patricia JN Davis, FNP-C

  • Family Nurse Practitioner
  • Massillon, OH
National Provider Identifier
1356994685
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0027444 Issued in OH
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

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
RN.430577OtherOHBOARD 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201221002690 OH Practitioner - Nurse Practitioner 9931511656 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN.430577OHMDRegistered Nurse
0027444OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oh Independent Medical Group LLC CurrentSince Jun 15, 2025 Accepting new patients
Oh Independent Medical Group LLC CurrentSince Jun 15, 2025 Accepting new patients
Paragon Heart Group, Inc PastSince Dec 26, 2000 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.