Individual provider Active NPI

Devyn Gabrielle Davis, PA-C

  • Physician Assistant
  • East Stroudsburg, PA
National Provider Identifier
1487498655
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
420 Supreme CT
East Stroudsburg, PA 18302-6800
Phone
(570) 213-3300
NPI assigned
Jun 22, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

420 Supreme CT
East Stroudsburg, PA 18302-6800

Mailing address

251 Yostville Rd
Covington Township, PA 18444-7936
Phone (570) 445-0419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20241021001822 PA Practitioner - Physician Assistant 5294267845 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Physician Assistant CurrentSince Sep 23, 2024 Accepting new patients
Geisinger Clinic CurrentSince Sep 23, 2024 Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

3 W Olive St
Scranton, PA 18508
Phone (570) 207-4054

675 Baltimore Dr
Wilkes Barre, PA 18702
Phone (570) 808-5757

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1719014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1487498655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 YOSTVILLE RD",
            "city": "COVINGTON TOWNSHIP",
            "state": "PA",
            "postal_code": "184447936",
            "telephone_number": "570-445-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 SUPREME CT",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183026800",
            "telephone_number": "570-213-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DEVYN",
        "middle_name": "GABRIELLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-22",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.