Individual provider Active NPI

Rachel Renee Davidson

  • Family Nurse Practitioner
  • Livingston, TN
National Provider Identifier
1386229151
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
29255 Issued in TN
Practice address
5880 Bradford Hicks Dr
Livingston, TN 38570-2236
Phone
(931) 823-6260
Fax
(931) 823-5821
NPI assigned
Mar 13, 2021
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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 29255 TN Primary

Addresses

Primary practice location

5880 Bradford Hicks Dr
Livingston, TN 38570-2236

Mailing address

1100 England Dr
Cookeville, TN 38501-0924
Phone (931) 520-4466

Other practice location 1

562 W Main St
Cookeville, TN 38506-5382
Phone (931) 854-9601

Other practice location 2

317 W Spring St
Cookeville, TN 38501-7102
Phone (931) 526-9518

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
I20210407002055 TN Practitioner - Nurse Practitioner 9032526165 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

105 S Willow Ave
Cookeville, TN 38501-4667
Phone (931) 526-9518

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.09 of 100Reported as group
Quality
50.47
Promoting interoperability
99
Improvement activities
40
Cost
67.33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29255TNMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Clinic, PC CurrentSince Aug 1, 2022 Accepting new patients
State of Tennessee CurrentSince Oct 9, 2023 Accepting new patients
State of Tennessee Current Accepting new patients
State of Tennessee CurrentSince Oct 9, 2023 Accepting new patients
Campbell Clinic PC CurrentSince Aug 1, 2022 Accepting new patients

Locations

105 S Willow Ave
Cookeville, TN 38501
Phone (931) 372-7716

105 S Willow Ave
Ste 100
Cookeville, TN 38501
Phone (931) 267-4929

1100 England Dr
Cookeville, TN 38501
Phone (931) 528-7531

317 W Spring St
Cookeville, TN 38501
Phone (931) 520-9250

5880 Bradford Hicks Dr
Livingston, TN 38570
Phone (931) 823-6260

1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111

Interoperability endpoints

  • Direct secure messaging: rachel.davidson.1@1366.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1615593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1386229151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 ENGLAND DR",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010924",
            "telephone_number": "931-520-4466",
            "fax_number": "931-520-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 BRADFORD HICKS DR",
            "city": "LIVINGSTON",
            "state": "TN",
            "postal_code": "385702236",
            "telephone_number": "931-823-6260",
            "fax_number": "931-823-5821"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "562 W Main St",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385065382",
            "country_code": "US",
            "telephone_number": "931-854-9601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "317 W Spring St",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385017102",
            "country_code": "US",
            "telephone_number": "931-526-9518",
            "fax_number": "931-372-0087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "RACHEL",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-13",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "29255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, TN

Sources for this page

Verify at the official NPI Registry.