Hallie Caroline Davis, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2024020241 Issued in MO

Practice address

1081 E 18TH St
Rolla, MO 65401-2448

Phone

(573) 426-4455

Fax

(573) 426-6723

NPI assigned

Jun 4, 2024

Last updated

Jun 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Central Missouri Community Health CenterGroup PAC ID 1355513581, 13 clinicians

Harrison County Community Hospital DistrictGroup PAC ID 4587630926, 21 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Harrison County Community Hospital Hospital, Bethany, MO, CCN 261312

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• South Central Missouri Community Health Center

  dba Four Rivers Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Rolla, MO
  • NPI 1164669172
  Medicare reassignment Care Compare group NPD
• Harrison County Community Hospital District

  dba Bethany Medical Clinic

  • Rural Health Clinic/Center
  • Bethany, MO
  • NPI 1154645745
  Medicare reassignment Care Compare group
• South Central Missouri Community Health Center

  dba Four Rivers Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Salem, MO
  • NPI 1194615757
  NPD
• South Central Missouri Community Health Center

  dba Four Rivers Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Rolla, MO
  • NPI 1346079613
  NPD

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

• Harrison County Community Hospital District

  dba Harrison County Community Hospital

  • Critical Access Hospital
  • Bethany, MO
  • NPI 1528062569
  Care Compare affiliation

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1366283269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 E 18TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012448",
            "telephone_number": "573-426-4455",
            "fax_number": "573-426-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 E 18TH ST",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012448",
            "telephone_number": "573-426-4455",
            "fax_number": "573-426-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "HALLIE",
        "middle_name": "CAROLINE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2024020241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel B Bruin DMD LLC
• Gina Marie Daniels, P.T.
• Sean M Danker-Smith, LPC
• Michelle Daron, LPN
• Lynne Grace Davidson, MA, LPC
• Katherine Ryan Davis, L.P.N.
• Kirk Davis, NP
• Lesa Elaine Davis, PA C
• Lisa Davis, LPC
• Mason McMillian Davis, PHARM.D.

• Family Nurse Practitioner in Rolla, MO
• Providers in Rolla, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.