Individual provider Active NPI

Teresa Dianne Davis, NP

  • Family Nurse Practitioner
  • Lewisburg, TN
National Provider Identifier
1376863191
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000015005 Issued in TN
Practice address
529 W Commerce St
Lewisburg, TN 37091-3219
Phone
(931) 270-9729
NPI assigned
Jun 3, 2010
Last updated
Oct 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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 APN0000015005 TN Primary

Addresses

Primary practice location

529 W Commerce St
Lewisburg, TN 37091-3219

Mailing address

529 W Commerce St
Lewisburg, TN 37091-3219
Phone (931) 270-9729

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
I20110614000429 TN Practitioner - Nurse Practitioner 8628255981 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN0000015005TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maury Regional Hospital Current Accepting new patients
Maury Regional Hospital CurrentSince Sep 8, 2015 Accepting new patients
Maury Regional Hospital Current Accepting new patients
Celebration Family Care PLLC Current Accepting new patients
Maury Regional Hospital CurrentSince Sep 8, 2015 Accepting new patients
Maury Regional Hospital Marshall Medical Center Past Accepting new patients

Locations

617 W Main St
Hohenwald, TN 38462
Phone (931) 796-4901

529 W Commerce St
Lewisburg, TN 37091
Phone (931) 270-9729

200 S Cross Bridges Rd
Mt Pleasant, TN 38474
Phone (931) 379-5821

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3755/brand/2/csg/1/fhir/r4

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1376863191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 W COMMERCE ST",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "370913219",
            "telephone_number": "931-270-9729",
            "fax_number": "931-270-9926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 W COMMERCE ST",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "370913219",
            "telephone_number": "931-270-9729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TERESA",
        "middle_name": "DIANNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000015005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, TN

Sources for this page

Verify at the official NPI Registry.