Tara Patricia Davis, RN, MSN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

27964 Issued in SC

Practice address

115 King Lees CT
Lexington, SC 29072-7089

Phone

(803) 239-4660

Fax

(803) 233-4656

NPI assigned

Aug 1, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, SC2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Transitional Wellness Center

  • Family Nurse Practitioner
  • Lexington, SC
  • NPI 1487486221
  NPD Authorized official
• Winslow Indian Health Care Center, Inc

  • Federal Public Health Clinic/Center
  • Winslow, AZ
  • NPI 1184729493

  TX

  Medicare reassignment
• Dilkon Medical Center

  • Federal Public Health Clinic/Center
  • Dilkon, AZ
  • NPI 1306016126
  NPD
• Winslow Indian Health Care Center, Inc

  dba Leupp Health Station

  • Federal Public Health Clinic/Center
  • Leupp, AZ
  • NPI 1760652580
  NPD
• Quad/Med, LLC

  • Primary Care Clinic/Center
  • Macon, GA
  • NPI 1649788191
  NPD (past)

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1649460080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 EAST MAIN STREET SUITE E #6 LEXINGTON, SC 29072",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290723440",
            "telephone_number": "803-239-4660",
            "fax_number": "803-233-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 KING LEES CT",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290727089",
            "telephone_number": "803-239-4660",
            "fax_number": "803-233-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TARA",
        "middle_name": "PATRICIA",
        "credential": "RN, MSN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024168713",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN274303",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "27964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024905300",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Davis
• Michael Davis
• Nikita Ra'Shonda Davis
• Rasheem Davis
• Shantell Lashawn Davis, CNA
• Alvin Day, M.D.
• Lindsey McWilliams Day, M.S. CCC-SLP
• DD&R Financial LLC (BrightStar of Lexington/West Columbia)
• Virginia Connor De Jesus, RN
• John Simons De Mailly, ATC

• Family Nurse Practitioner in Lexington, SC
• Providers in Lexington, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.