Jennifer Elizabeth Davis, FNPC
Individual provider Active NPI Family Nurse Practitioner · Cheyenne, WY
NPI 1447572136 · NPPES record last updated Aug 31, 2022
Key facts
- NPI
- 1447572136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 20951.1029 (WY)
- Practice address
- 1202 Cleveland Ave Ste 1
Cheyenne, WY 82001-6700 - Phone
- (307) 426-4916
- Fax
- (877) 585-7008
- NPI assigned
- Feb 22, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1202 Cleveland Ave
Cheyenne, WY 82001-6700
Phone (307) 214-4537
Hospital & facility affiliations
- Enhabit Home Health
- Eden Home Health
- Cheyenne Regional Medical Center Home Care Services
- Cheyenne Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WY
- 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 |
|---|---|---|---|---|
| I20100324001231 | WY | Practitioner - Nurse Practitioner | 7214063643 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1029 | WY | MD | Physical Therapist |
| 20951.1029 | WY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genuine Care Healthcare Systems LLC | Current |
Accepting new patients |
Locations
1202 Cleveland Ave
Ste 1
Cheyenne, WY 82001
Phone (307) 426-4916
1202 Cleveland Ave
Cheyenne, WY 82001
Phone (307) 632-1657
Interoperability endpoints
- jdavis@gchsl-wy.direct.office.nextgen.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 20951.1029 | WY | Yes |
Addresses
Primary practice location
1202 Cleveland Ave Ste 1
Cheyenne, WY 82001-6700
Mailing address
1202 Cleveland Ave Ste 1
Cheyenne, WY 82001-6700
Phone (307) 426-4916
Other providers in Cheyenne, WY
- A'Leah Syare Davis
- Abby Renae Davis
- Carmen S. Davis
- Carol A Davis
- James Davis
- Jennifer Lee Davis
- Meade O Davis III
- Polly Ann Davis
- Randall Thomasson Davis
- Shadi Alikhani Davis
All providers in Cheyenne, WY · Family Nurse Practitioner in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2022. 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.