Individual provider Active NPI

Gina C Davis, FNP-C

  • Family Nurse Practitioner
  • Avon, IN
National Provider Identifier
1669474631
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71000185A Issued in IN
Practice address
8607 E US Highway 36 Ste 100
Avon, IN 46123-7960
Phone
(317) 208-3855
Fax
(317) 718-6612
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28114408A IN
Adult Health Nurse Practitioner 363LA2200X 71000185A IN
Family Nurse Practitioner 363LF0000X 71000185A IN Primary

Addresses

Primary practice location

8607 E US Highway 36 Ste 100
Avon, IN 46123-7960

Mailing address

8607 E US Highway 36 Ste 100
Avon, IN 46123-7960
Phone (317) 208-3855

Other identifiers 1

IdentifierTypeStateIssuer
200504790MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20041117000428 IN Practitioner - Nurse Practitioner 2961466131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

8607 E US Hwy 36
Suite 100
Avon, IN 46123-7960
Phone (317) 745-5403

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
69.89 of 100Reported as group
Promoting interoperability
56
Improvement activities
40
Cost
76.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71000185AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Health Network of Indiana LLC CurrentSince Oct 14, 2024 Accepting new patients
American Health Network of Indiana, LLC CurrentSince Oct 14, 2024 Accepting new patients
American Health Network of Indiana, LLC Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

8607 E US Highway 36
Ste 100
Avon, IN 46123
Phone (317) 208-3855

10995 Allisonville Rd
Ste 100
Fishers, IN 46038
Phone (317) 842-7928

1500 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-5041

7440 Woodland Dr
Indianapolis, IN 46278
Phone (317) 450-3357

Interoperability endpoints

  • Direct secure messaging: gdavis211643@direct.optum.com
  • Direct secure messaging: gdavis@jwmn.gwaydirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1669474631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8607 E US HIGHWAY 36 STE 100",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237960",
            "telephone_number": "317-208-3855",
            "fax_number": "317-718-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8607 E US HIGHWAY 36 STE 100",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237960",
            "telephone_number": "317-208-3855",
            "fax_number": "317-718-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GINA",
        "middle_name": "C",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28114408A",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71000185A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000185A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200504790",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

Verify at the official NPI Registry.