Active NPI
Judy Davis, RN
- Registered Nurse
- Jacksonville, AR
National Provider Identifier
1578697371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R09905
- Practice address
- 2520 W Main St
Co Pathfinder Inc
Jacksonville, AR 72076-4214 - Phone
- (501) 982-0528
- Fax
- (501) 985-7777
- NPI assigned
- Mar 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R09905 | AR | Primary |
Addresses
Primary practice location
2520 W Main St
Co Pathfinder Inc
Jacksonville, AR 72076-4214
Mailing address
2520 W Main St
Co Pathfinder Inc
Jacksonville, AR 72076-4214
Phone (501) 982-0528
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R09905 | Other | AR | RN LISENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R09905 | AR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578697371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2520 W MAIN ST",
"address_2": "CO PATHFINDER INC",
"city": "JACKSONVILLE",
"state": "AR",
"postal_code": "720764214",
"telephone_number": "501-982-0528",
"fax_number": "501-985-7777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2520 W MAIN ST",
"address_2": "CO PATHFINDER INC",
"city": "JACKSONVILLE",
"state": "AR",
"postal_code": "720764214",
"telephone_number": "501-982-0528",
"fax_number": "501-985-7777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JUDY",
"name_prefix": "Mrs.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AR",
"license": "R09905",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LISENSE",
"identifier": "R09905",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.