Individual provider Active NPI

Jeanne Ann Davis, F.N.P.

  • Nurse Practitioner
  • Sterling, CO
National Provider Identifier
1639398357
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP-1966 Issued in CO
Practice address
620 Iris Dr
Sterling, CO 80751-4716
Phone
(970) 522-7266
Fax
(970) 522-4258
NPI assigned
Apr 24, 2007
Last updated
Mar 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP-1966 CO Primary
Adult Health Nurse Practitioner 363LA2200X 46792 CO

Addresses

Primary practice location

620 Iris Dr
Sterling, CO 80751-4716

Mailing address

2695 Rocky Mountain Ave
Suite 150
Loveland, CO 80538-8702
Phone (970) 624-4443

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-1966COMDNurse Practitioner
46792COMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
High Country Internal Medicine, P.C. Current Accepting new patients
Poudre Valley Medical Group, LLC Past Accepting new patients

Locations

620 Iris Dr
Sterling, CO 80751
Phone (970) 313-2740

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1639398357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE",
            "address_2": "SUITE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805388702",
            "telephone_number": "970-624-4443",
            "fax_number": "970-490-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 IRIS DR",
            "city": "STERLING",
            "state": "CO",
            "postal_code": "807514716",
            "telephone_number": "970-522-7266",
            "fax_number": "970-522-4258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JEANNE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "NP-1966",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CO",
            "license": "46792",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.