Leann C Davidson, ARNP
Individual provider Active NPI Family Nurse Practitioner · Chipley, FL
NPI 1407140478 · NPPES record last updated Feb 20, 2013
Key facts
- NPI
- 1407140478
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- ARNP3402062 (FL)
- Practice address
- 1376 Brickyard Rd Ste 5
Chipley, FL 32428-6392 - Phone
- (850) 415-6781
- Fax
- (850) 415-6783
- NPI assigned
- Jun 7, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 10
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northwest Florida Healthcare, Inc.
Practice addresses (Care Compare)
3250 Main St
Vernon, FL 32462-2223
Phone (850) 535-2096
Hospital & facility affiliations
- Centerwell Home Health
- Northwest Florida Community Hospital
- Doctors Memorial Hospital
- Flowers Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110621000344 | FL | Practitioner - Nurse Practitioner | 7810175973 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Florida Healthcare, Inc | Current |
Accepting new patients | |
| Southland Hospitlalist at Chipley, PL. | Current |
Accepting new patients | |
| Northwest Florida Healthcare, Inc | Current |
Accepting new patients | |
| Northwest Florida Healthcare, Inc. | Past | Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
1360 Brickyard Rd
Fl Co
Chipley, FL 32428
Phone (850) 638-1610
1376 Brickyard Rd
Ste 5
Chipley, FL 32428
Phone (850) 638-4383
1360 Brickyard Rd
Chipley, FL 32428
Phone (850) 415-8300
3250 Main St
Vernon, FL 32462
Phone (850) 535-2096
Interoperability endpoints
- leann.davidson.1@14612.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | ARNP3402062 | FL | Yes |
Addresses
Primary practice location
1376 Brickyard Rd Ste 5
Chipley, FL 32428-6392
Mailing address
1376 Brickyard Rd Ste 5
Chipley, FL 32428-6392
Phone (850) 415-6781
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005480000 | Medicaid | FL |
Other providers in Chipley, FL
- Rizza Liza Alcantara Cordero
- Nancy Cota
- William Edwin Cox III
- CRNC, LLC
- Chelsea R Dalton
- Christy E. Davis-Wester
- Dawn Rene', Inc.
- Deborah B Day
- Dermatology Associates
- Dermatology Associates, PA
All providers in Chipley, FL · Family Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.