Jaqueline Margaret Davis, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN143842 Issued in GA

Practice address

527 Eisenhower Drive
Savannah, GA 31406

Phone

(912) 819-9100

Fax

(912) 819-9101

NPI assigned

Jul 24, 2006

Last updated

Jun 14, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in GA

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

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• SJC Medical Group Inc

  • Family Medicine Physician
  • Savannah, GA
  • NPI 1811233828
  NPD

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1518989078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 E. 65TH STREET",
            "address_2": "SUITE 22",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-819-7878",
            "fax_number": "912-819-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 EISENHOWER DRIVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31406",
            "telephone_number": "912-819-9100",
            "fax_number": "912-819-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAQUELINE",
        "middle_name": "MARGARET",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN143842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01067491",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OLD MEDICARE PTAN",
            "identifier": "50BBLLG",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "593466638A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "404178",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00394154",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric K Davis, MD
• Frank Etheridge Davis III, M.D.
• Haley Davis, PT, DPT
• India Patrina Davis
• Janalee Davis, M.D.
• Jennifer Marie Davis
• Jordan Bradley Davis
• Katherine Nettie Davis, ACNP
• Keyotta Davis, RBT
• Kiswana Davis, RBT

• Nurse Practitioner in Savannah, GA
• Providers in Savannah, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.