Individual provider Active NPI

Valen Verona Davis, ARNP

  • Family Nurse Practitioner
  • Miramar, FL
National Provider Identifier
1396057915
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9265657 Issued in FL
Practice address
10910 Pembroke Rd
Miramar, FL 33025-1706
Phone
(954) 276-5552
Fax
(954) 443-4737
NPI assigned
Jul 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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 ARNP9265657 FL Primary

Addresses

Primary practice location

10910 Pembroke Rd
Miramar, FL 33025-1706

Mailing address

2900 Corporate Way
Door D
Miramar, FL 33025-3925
Phone (954) 276-5685

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vdavis194725@MHSDIRECT.NET Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180912000676 FL Practitioner - Nurse Practitioner 5193909224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

10910 Pembroke Rd
Miramar, FL 33025-1706
Phone (954) 265-8100

3501 Johnson St
Hollywood, FL 33021-5421
Phone (954) 265-9976

Hospital & facility affiliations

  • Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
  • Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Aug 1, 2018 Accepting new patients
South Broward Hospital District Current Accepting new patients
South Broward Hospital District CurrentSince Aug 1, 2018 Accepting new patients
South Broward Hospital District Past Accepting new patients

Locations

10910 Pembroke Rd
Miramar, FL 33025
Phone (954) 265-8100

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

3501 Johnson St
Pembroke Park, FL 33021
Phone (954) 265-2000

Interoperability endpoints

  • Direct secure messaging: vdavis194725@mhsdirect.net

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 and National Provider Directory roles.

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": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1396057915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY",
            "address_2": "DOOR D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5685",
            "fax_number": "954-985-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10910 PEMBROKE RD",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330251706",
            "telephone_number": "954-276-5552",
            "fax_number": "954-443-4737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "VALEN",
        "middle_name": "VERONA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-12",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9265657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vdavis194725@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10910 Pembroke Rd",
            "city": "Miramar",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330251706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.