Individual provider Active NPI

Darel Louis Davis, APN, FNP-C

  • Family Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1366749707
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
15569 Issued in TN
Practice address
8040 Wolf River Blvd Ste 103
Germantown, TN 38138-1773
Phone
(901) 726-0200
Fax
(901) 278-3050
NPI assigned
Feb 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 15569 TN Primary

Addresses

Primary practice location

8040 Wolf River Blvd Ste 103
Germantown, TN 38138-1773

Mailing address

8459 E Askersund CV
Cordova, TN 38018-6836
Phone (901) 237-6388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20110527000553 TN Practitioner - Nurse Practitioner 8628255601 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health of Tennessee LLC Family CurrentSince Mar 10, 2021 Accepting new patients
Southeastern Emergency Services P C Past Accepting new patients

Locations

1509 Dulles Dr
Lafayette, LA 70506
Phone (337) 408-0803

5865 Ridgeway Center Pkwy
Memphis, TN 38120
Phone (901) 219-1295

Organizations & group practices 2

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": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1366749707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8459 E ASKERSUND CV",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380186836",
            "telephone_number": "901-237-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 WOLF RIVER BLVD STE 103",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381773",
            "telephone_number": "901-726-0200",
            "fax_number": "901-278-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DAREL",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "APN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-22",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "15569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.