Latisha Shuntise Davis, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN062309 Issued in GA

Practice address

415 N Jackson St
Americus, GA 31709-3015

Phone

(229) 931-4425

Fax

(229) 931-2474

NPI assigned

Jul 29, 2011

Last updated

Jul 29, 2011By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Graceful Guardians Health Care LLC

  • Home Health Agency
  • Americus, GA
  • NPI 1487469870
  NPD Authorized official

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1477831113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N JACKSON ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093015",
            "telephone_number": "229-931-4425",
            "fax_number": "229-931-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N JACKSON ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093015",
            "telephone_number": "229-931-4425",
            "fax_number": "229-931-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "LATISHA",
        "middle_name": "SHUNTISE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN062309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Damon
• Samantha Daniel, PHARMD
• Daughters of the King Ministries Inc.
• David K. Taing, M.D., D.C, P.C.
• Brian D Davis, ATC
• Bria Dennard
• Schenita Dennard
• Jani Dennis, FNP
• Laura McMaster Depaola, PH.D.
• Quaison Trentus Dey, M.D.

• Licensed Practical Nurse in Americus, GA
• Providers in Americus, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.