Shelly Denice Davis, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN089222 Issued in GA

Practice address

612 Love Avenue
Tifton, GA 31794

Phone

(229) 391-3300

Fax

(229) 388-1948

NPI assigned

Jun 18, 2008

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tift Regional Medical Center Hospital, Tifton, GA, CCN 110095
• Colquitt Regional Medical Center Hospital, Moultrie, GA, CCN 110105
• Southwell Medical, a Campus of TRMC Hospital, Adel, GA, CCN 110101

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: sdavis@fpatifton.gwaydirect.com
• Direct secure messaging: shelly.davis.1@8042.direct.athenahealth.com

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.

• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857
  Medicare reassignment Care Compare group NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273
  NPD
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)

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

• Colquitt Regional Medical Center

  • General Acute Care Hospital
  • Moultrie, GA
  • NPI 1912099094
  Care Compare affiliation
• Colquitt Regional Medical Center

  • Psychiatric Hospital Unit
  • Moultrie, GA
  • NPI 1982295036
  Care Compare affiliation
• Tift Regional Health System Inc.

  • General Acute Care Hospital
  • Tifton, GA
  • NPI 1962462226
  Care Compare affiliation
• Tift Regional Health System, Inc.

  • General Acute Care Hospital
  • Adel, GA
  • NPI 1568410264
  Care Compare affiliation

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1386805885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 LOVE AVENUE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "31794",
            "telephone_number": "229-391-3300",
            "fax_number": "229-388-1948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 LOVE AVENUE",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "31794",
            "telephone_number": "229-391-3300",
            "fax_number": "229-388-1948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHELLY",
        "middle_name": "DENICE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN089222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "481466728A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Lynn Davis, APRN-C
• Markeshia Franshae Davis
• Marleshia Terrian Davis
• Monica R Davis, APRN
• Shelley Nichole Davis, PHARMD
• William H Davis, MD
• Larry Day
• Sandra Day, L.D.O
• Roxann Elaine Deen, FNP-C
• Sanjay Desai, DO

• Nurse Practitioner in Tifton, GA
• Providers in Tifton, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.