Shanedra Rachelle Davis, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61139752 Issued in WA

Practice address

485 Rainier Ave S Ste B
Renton, WA 98057-2428

Phone

(281) 793-0437

NPI assigned

Jan 27, 2012

Last updated

Feb 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, WA2 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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shanedra.davis.p1@direct.alegiscare.nextgenshare.com
• Direct secure messaging: shanedra.davis.p2@direct.alegiscare.nextgenshare.com

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  WA

  Medicare reassignment NPD
• Vpa of Texas PLLC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Irving, TX
  • NPI 1679510499
  Medicare reassignment NPD
• Diversified Health & Wellness Solutions, LLC

  • Health Service Clinic/Center
  • Fresno, TX
  • NPI 1518633445
  NPD Authorized official
• Guided by Grace Home Care LLC

  • In Home Supportive Care Agency
  • Fresno, TX
  • NPI 1356262349
  NPD (past) Authorized official
• Vpa of Texas PLLC

  • Clinical Social Worker
  • San Antonio, TX
  • NPI 1578175865
  NPD

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1477825099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2923 ASHLYN ARBOR DR",
            "city": "FRESNO",
            "state": "TX",
            "postal_code": "775452152",
            "telephone_number": "281-793-0437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 RAINIER AVE S STE B",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572428",
            "telephone_number": "281-793-0437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2923 Ashlyn Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "TX",
            "postal_code": "775452152",
            "country_code": "US",
            "telephone_number": "281-793-0437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHANEDRA",
        "middle_name": "RACHELLE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-27",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139333",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61139752",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "792827",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calvin Eugene Davis, DPM
• Charles J Davis, PA-C
• Kent S. Davis, M.D., F.A.C.O.G.
• Mary Ann Davis
• Monique Davis
• Todd Reginald Davis, MD
• Samaneh Davoudimoghaddam, MD
• Dawn Flynn, ND, Lac
• Dawn S. Flynn
• Allison E Dawood, PT

• Family Nurse Practitioner in Renton, WA
• Providers in Renton, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.