Individual provider Active NPI

Jerry Rene Davila

  • Acute Care Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1568836005
Registry record updated Nov 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
648503 Issued in TX
Practice address
7700 Floyd Curl
San Antonio, TX 78229
Phone
(210) 575-4000
NPI assigned
Nov 20, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 648503 TX Primary

Addresses

Primary practice location

7700 Floyd Curl
San Antonio, TX 78229

Mailing address

PO Box 2776
San Antonio, TX 78299-2776
Phone (210) 558-6288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220207001730 TX Practitioner - Nurse Practitioner 1759774110 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
648503TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Ips LLC CurrentSince Apr 1, 2022 Accepting new patients
Apexmed, PLLC CurrentSince Jan 1, 2023 Accepting new patients
Apexcare PLLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

34910 Interstate 10 W
Ste 601
Boerne, TX 78006
Phone (830) 248-1207

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

4499 Medical Dr
#150
San Antonio, TX 78229
Phone (210) 614-8181

1139 E Sonterra Blvd
San Antonio, TX 78258
Phone (210) 638-2000

4458 Medical Dr
Ste 505
San Antonio, TX 78229

4085 De Zavala Rd
Ste 150
Shavano Park, TX 78249
Phone (210) 368-6614

4085 De Zavala Rd
Ste 200
Shavano Park, TX 78249
Phone 2105586288123

Organizations & group practices 3

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": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731715200000",
    "number": "1568836005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2776",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782992776",
            "telephone_number": "210-558-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 FLOYD CURL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-575-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "JERRY",
        "middle_name": "RENE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-20",
        "last_updated": "2024-11-16",
        "certification_date": "2024-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "648503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.