Davita Medical Home LLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

DAVITA MEDICAL HOME LLC

Practice address

745 Battlefield Blvd N Ste 100
Chesapeake, VA 23320-0305

Phone

(757) 312-8346

NPI assigned

Nov 24, 2025

Last updated

Apr 28, 2026By the provider in NPPES

Organization subpart

Yes

Parent organization

DAVITA INCAs reported in NPPES

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

Authorized official

Name

Samuel T Wey

Title

VP, Licensure & Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Part of

Davita Inc

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dominique J Hawkins, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Chesapeake, VA
  • NPI 1710527544
  Medicare reassignment

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

{
    "created_epoch": "1763942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777334400000",
    "number": "1588525935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 16TH ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802025117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 BATTLEFIELD BLVD N STE 100",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200305",
            "telephone_number": "757-312-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA MEDICAL HOME LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVITA INC",
        "enumeration_date": "2025-11-24",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
        "authorized_official_telephone_number": "615-341-6641"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Overstreet Davis, LPC, RPT
• Thomas Preston Davis, M.D.
• Tia Davis
• Tina Marie Davis, RN
• Zeriah Davis, BIRTH DOULA
• Elizabeth Cameron Grim Dawson, WHNP-BC
• Janet Miller Dawson, PMHNP
• Day Support Services of Virginia
• Days of Victory Center for Autism Inc
• Kristen Bedoya De la Cerda, PHARM.D.

• Adult Health Nurse Practitioner in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Adult Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.