Portia O Davis, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F340367 Issued in NY

Practice address

1205 Troy Schenectady Rd Ste 101
Latham, NY 12110-1074

Phone

(518) 348-3176

NPI assigned

Aug 29, 2016

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pdavis@hiemail.healtheconnections.org
• Direct secure messaging: pdavis@landmarkhealth-direct.org

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.

• Schenectady Family Health Services, Inc.

  • Family Medicine Physician
  • Schenectady, NY
  • NPI 1396711982
  Medicare reassignment NPD
• Schenectady Family Health Services, Inc.

  • Dental Clinic/Center
  • Schenectady, NY
  • NPI 1457024218
  NPD

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1497201511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 STATE ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123071508",
            "telephone_number": "518-370-1441",
            "fax_number": "518-395-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 TROY SCHENECTADY RD STE 101",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121101074",
            "telephone_number": "518-348-3176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1044 State St",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123071508",
            "country_code": "US",
            "telephone_number": "518-370-1441 x4155",
            "fax_number": "518-395-9431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "PORTIA",
        "middle_name": "O",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-29",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F340367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02995513",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David F. Cryns, D.O., OB /GYN
• David J. Vallecorsa DDS PLLC
• Barry Davis, LCSW-E
• Emily Davis, MA, LMHC
• James Sherwood Davis Jr., MS, CAS, LMHC
• Michele Day, LMHC
• Elsa I Deboy, PHARMD
• Paroda Loy Decavallas, LMHC
• Lindsay Dechow, OT
• Jason Thomas Decker, D.D.S.

• Family Nurse Practitioner in Latham, NY
• Providers in Latham, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; 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.