Individual provider Active NPI

Thea A Davis, DNP

  • Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1508335159
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP11430 Issued in AZ
Practice address
2152 S Vineyard Ste 129
Mesa, AZ 85210-6882
Phone
(480) 443-8400
NPI assigned
Nov 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP11430 AZ
Nurse Practitioner 363L00000X AP11430 AZ Primary
Gerontology Nurse Practitioner 363LG0600X AP11430 AZ

Addresses

Primary practice location

2152 S Vineyard Ste 129
Mesa, AZ 85210-6882

Mailing address

7544 E Irwin Ave
Mesa, AZ 85209-4130
Phone (480) 443-8400

Other practice location 1

3645 S Rome St Ste 201
Gilbert, AZ 85297-7338
Phone (480) 443-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20190214000837 AZ Practitioner - Nurse Practitioner 4486992617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona Arthritis and Rheumatology Associates P CGroup PAC ID 8123912516, 63 clinicians

Practice addresses (Care Compare)

3645 S Rome St
Suite 201
Gilbert, AZ 85297-7338
Phone (480) 443-8400

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: thea.davis.p1@direct.aara.nextgenshare.com

Organizations & group practices 1

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": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1508335159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7544 E IRWIN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852094130",
            "telephone_number": "480-443-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2152 S VINEYARD STE 129",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106882",
            "telephone_number": "480-443-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3645 S Rome St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852977338",
            "country_code": "US",
            "telephone_number": "480-443-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "THEA",
        "middle_name": "A",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "AP11430",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP11430",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "AP11430",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.