Melissa La Russo Davis, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

5001556 Issued in NC

Practice address

14214 Ballantyne Lake Rd
Charlotte, NC 28277-3372

Phone

(704) 667-2600

NPI assigned

Jun 1, 2011

Last updated

Aug 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, VA2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdavis1102571@direct.novanthealth.org

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.

• NH Digital Health Services, LLC

  dba Novant Health Digital Care Group

  • Family Medicine Physician
  • Winston Salem, NC
  • NPI 1427683044
  Medicare reassignment NPD
• NH Digital Health Services, LLC

  dba Novant Health Digital Care Group

  • Family Medicine Physician
  • Manassas, VA
  • NPI 1134734437
  Medicare reassignment NPD
• NH Digital Health Services, LLC

  dba Novant Health Virtual Oncology Care

  • Hematology & Oncology Physician
  • Winston Salem, NC
  • NPI 1386506855
  NPD

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1437443090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14214 BALLANTYNE LAKE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773372",
            "telephone_number": "704-667-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14214 BALLANTYNE LAKE RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282773372",
            "telephone_number": "704-667-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MELISSA",
        "middle_name": "LA RUSSO",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-01",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5001556",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5001556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lopez Duane Davis II
• Madison Davis, PHARMD
• Matthew Davis, DPT
• Melissa A Davis, PT
• Melissa Elizabeth Davis, LCMHC
• Meredith Davis, LAT, ATC
• Micheal Davis
• Michelle Davis, LCSW
• Natalie Davis
• Nattia Davis, MS

• Pediatric Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Pediatric Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.