Jennifer A Davis

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

7769 Issued in WI

Practice address

160 Gateway Dr
Waupun, WI 53963-2276

Phone

(920) 324-9899

NPI assigned

Jul 20, 2017

Last updated

Oct 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, CO2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mid-South Home Care Services LLCGroup PAC ID 4385961093, 101 clinicians

Jvshealth LLCGroup PAC ID 0749621761, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: journeyofcare.jenniferdavis@162030.advancedmd-direct.com

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.

• Mid-South Home Care Services, LLC

  dba Empatia Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Milwaukee, WI
  • NPI 1710768213
  Medicare reassignment Care Compare group NPD
• Jvshealth LLC

  • Internal Medicine Physician
  • Hampton Bays, NY
  • NPI 1972303006

  CO

  Medicare reassignment Care Compare group NPD
• Journey of Care, LLC

  dba Journey of Care

  • In Home Supportive Care Agency
  • Denver, CO
  • NPI 1356147987

  Gerontology

  Medicare reassignment NPD
• The Holding Group, LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1669877155
  Medicare reassignment NPD
• Jvshealth LLC

  • Internal Medicine Physician
  • Hampton Bays, NY
  • NPI 1720832421
  NPD
• Mid-South Home Care Services, LLC

  dba Empatia Palliative Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Alpharetta, GA
  • NPI 1154207769
  NPD

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1619490711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 GATEWAY DR",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539632276",
            "telephone_number": "920-324-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 GATEWAY DR",
            "city": "WAUPUN",
            "state": "WI",
            "postal_code": "539632276",
            "telephone_number": "920-324-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "7769",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WI",
            "license": "7769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Psychological Services of Waupun LLC
• Consultants Laboratory of Wisconsin, LLC
• Consultants Laboratory of Wisconsin, LLC
• Carole Marie Cronin, R.PH.
• Melissa Jean Czerwinski, FNP-BC
• Shamiah M Dekker, CRNA
• Gary L Dent, CRNA
• Ahmed Hassan Dessouki, M.D.
• Sheri Jane Dewar
• Robert Norman Deyoung, PHD

• Gerontology Nurse Practitioner in Waupun, WI
• Providers in Waupun, WI by specialty
• Gerontology Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.