Individual provider Active NPI

Charlotte Lynn Davis, NP

  • Family Nurse Practitioner
  • Richland, WA
National Provider Identifier
1487099792
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60491292 Issued in WA
Practice address
1480 Fowler St
Richland, WA 99352-4717
Phone
(951) 929-6003
NPI assigned
May 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60491292 WA Primary

Addresses

Primary practice location

1480 Fowler St
Richland, WA 99352-4717

Mailing address

2503 S Highlands Blvd
West Richland, WA 99353-6766
Phone (509) 430-9659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20150702000353 WA Practitioner - Nurse Practitioner 4385870658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
HeartlinksGroup PAC ID 3678477395, 2 clinicians

Practice addresses (Care Compare)

204 W 2ND St
Grandview, WA 98930-1361
Phone (509) 837-1676

Hospital & facility affiliations

  • Tri-Cities Home Health Home health agency, Kennewick, WA, CCN 507010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heartlinks CurrentSince Feb 9, 2021 Accepting new patients
Heartlinks CurrentSince Feb 9, 2021 Accepting new patients

Locations

204 W 2nd St
Grandview, WA 98930
Phone (509) 837-1676

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1487099792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 S HIGHLANDS BLVD",
            "city": "WEST RICHLAND",
            "state": "WA",
            "postal_code": "993536766",
            "telephone_number": "509-430-9659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 FOWLER ST",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524717",
            "telephone_number": "951-929-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHARLOTTE",
        "middle_name": "LYNN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60491292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.