Individual provider Active NPI

Cortney A Davis, ARNP

  • Family Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1386088458
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20292 Issued in SC
Practice address
2660 Reidville Rd Unit 1
Spartanburg, SC 29301-3512
Phone
(864) 560-9696
Fax
(864) 562-5230
NPI assigned
Apr 19, 2013
Last updated
Dec 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9170031 FL
Family Nurse Practitioner 363LF0000X 20292 SC Primary
Occupational Health Nurse Practitioner 363LX0106X 20292 SC

Addresses

Primary practice location

2660 Reidville Rd Unit 1
Spartanburg, SC 29301-3512

Mailing address

2660 Reidville Rd Unit 1
Spartanburg, SC 29301-3512
Phone (864) 560-9696

Other identifiers 1

IdentifierTypeStateIssuer
NP4072MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cdavis77988@direct-srhs.et0939.epichosted.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160712002080 FL Practitioner - Nurse Practitioner 7315239399
I20161025003131 SC Practitioner - Nurse Practitioner 7315239399 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9170031FLMDFamily Nurse Practitioner
20292SCMDOccupational Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Aug 3, 2016 Accepting new patients
Spartanburg Medical Center CurrentSince Aug 3, 2016 Accepting new patients
Spartanburg Medical Center Past Accepting new patients

Locations

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

2660 Reidville Rd
Unit 1
Spartanburg, SC 29301
Phone (864) 560-9696

8311 Warren H Abernathy Hwy
Spartanburg, SC 29301
Phone (864) 562-5100

Interoperability endpoints

  • Direct secure messaging: cdavis77988@direct-srhs.et0939.epichosted.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, 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": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1386088458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 REIDVILLE RD UNIT 1",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293013512",
            "telephone_number": "864-560-9696",
            "fax_number": "864-560-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 REIDVILLE RD UNIT 1",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293013512",
            "telephone_number": "864-560-9696",
            "fax_number": "864-562-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CORTNEY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-19",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9170031",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20292",
            "primary": true
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "SC",
            "license": "20292",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP4072",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdavis77988@direct-srhs.et0939.epichosted.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "cdavis77988@direct-srhs.et0939.epichosted.com",
            "address_1": "2660 Reidville Rd Unit 1",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293013512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.