Individual provider Active NPI

Brianna Destiny Davis

  • Physician Assistant
  • Windsor Mill, MD
National Provider Identifier
1649050303
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0010042 Issued in MD
Practice address
7001 Johnnycake Rd Ste 107
Windsor Mill, MD 21244-2419
Phone
(516) 655-9652
NPI assigned
Oct 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0010042 MD Primary

Addresses

Primary practice location

7001 Johnnycake Rd Ste 107
Windsor Mill, MD 21244-2419

Mailing address

7001 Johnnycake Rd Ste 107
Windsor Mill, MD 21244-2419
Phone (516) 655-9652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD, VA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20250822001132 DC Practitioner - Physician Assistant 5395245518 Reassigns benefits to 1 organization
I20250822001870 MD Practitioner - Physician Assistant 5395245518 Reassigns benefits to 1 organization
I20251205003905 VA Practitioner - Physician Assistant 5395245518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psych Associates of Maryland LLC 151 clinicians

Practice addresses (Care Compare)

120 Sister Pierre Dr
Suite 403
Towson, MD 21204-7536
Phone (410) 823-6408

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Neta, Inc. PastSince Jan 21, 2020 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753920000000",
    "number": "1649050303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 JOHNNYCAKE RD STE 107",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442419",
            "telephone_number": "516-655-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 JOHNNYCAKE RD STE 107",
            "city": "WINDSOR MILL",
            "state": "MD",
            "postal_code": "212442419",
            "telephone_number": "516-655-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BRIANNA",
        "middle_name": "DESTINY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-02",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0010042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor Mill, MD

Sources for this page

Verify at the official NPI Registry.