Individual provider Active NPI

Carla Ann Davis

  • Nurse Practitioner
  • Murray, KY
National Provider Identifier
1457586638
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1106799 Issued in KY
Practice address
111 Poplar St Ste 104
Murray, KY 42071-2577
Phone
(270) 534-5128
Fax
(270) 477-0007
NPI assigned
May 18, 2009
Last updated
Aug 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1106799 KY Primary

Addresses

Primary practice location

111 Poplar St Ste 104
Murray, KY 42071-2577

Mailing address

200 Corporate Blvd
Suite 201
Lafayette, LA 70508-3870

Other practice location 1

2327 New Holt Rd
Paducah, KY 42001-7404
Phone (270) 534-5128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20090928000636 KY Practitioner - Nurse Practitioner 5294881512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emerald Therapy Center LLCGroup PAC ID 6103241211, 16 clinicians

Practice addresses (Care Compare)

111 Poplar St
Suite 104
Murray, KY 42071-2577
Phone (270) 534-5128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
15092TNMDPhysical Therapist
1106799KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emerald Therapy Center, LLC CurrentSince Jun 23, 2025 Accepting new patients
Emerald Therapy Center, LLC CurrentSince Jun 23, 2025 Accepting new patients

Locations

1019 Paducah Rd
Ste C
Mayfield, KY 42066
Phone (270) 534-5128

111 Poplar St
Ste 104
Murray, KY 42071
Phone (270) 534-5128

1640 McCracken Blvd
Ste 200
Paducah, KY 42001
Phone (270) 534-5128

2520 New Holt Rd
Ste I
Paducah, KY 42001
Phone (270) 558-3916

2327 New Holt Rd
Paducah, KY 42001
Phone (270) 534-5128

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1457586638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "address_2": "SUITE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 POPLAR ST STE 104",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712577",
            "telephone_number": "270-534-5128",
            "fax_number": "270-477-0007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2327 New Holt Rd",
            "address_purpose": "LOCATION",
            "city": "Paducah",
            "state": "KY",
            "postal_code": "420017404",
            "country_code": "US",
            "telephone_number": "270-534-5128",
            "fax_number": "270-477-0007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CARLA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "1106799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, KY

Sources for this page

Verify at the official NPI Registry.