Wesley Scott Davis, AGNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2021018043 Issued in MO

Practice address

101 N Elm St Ste D
Pierce City, MO 65723-1233

Phone

(417) 297-0515

Fax

(417) 429-4543

NPI assigned

May 20, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

State licenses

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 and National Provider Directory roles.

• Hometown Medical Group, LLC

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1295488195
  Medicare reassignment NPD

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1548834864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 DEER RUN ST",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657427553",
            "telephone_number": "870-391-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N ELM ST STE D",
            "city": "PIERCE CITY",
            "state": "MO",
            "postal_code": "657231233",
            "telephone_number": "417-297-0515",
            "fax_number": "417-429-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WESLEY",
        "middle_name": "SCOTT",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2021018043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark Community Mental Health Center
• Clark Community Mental Health Center
• Clark Community Mental Health Center
• Clark Community Mental Health Center
• Clark Community Mental Health Center
• Sheryl Kay Fuchs
• Christy Marie Henley, PMHNP-BC
• Melvin D. Hodde, DO
• Sandra Jo Houlihan
• Cathy Ingalls, WHNP

• Nurse Practitioner in Pierce City, MO
• Providers in Pierce City, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.