Individual provider Active NPI

Elizabeth E Davis, CNP

  • Family Nurse Practitioner
  • Millersport, OH
National Provider Identifier
1669732624
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN001646 Issued in NV
Practice address
485 Blacklick Rd
Millersport, OH 43046-9725
Phone
(740) 504-0277
NPI assigned
May 24, 2012
Last updated
Sep 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X COA.13011-NP OH
Family Nurse Practitioner 363LF0000X APRN11026902 FL
Family Nurse Practitioner 363LF0000X AP7391 AZ
Family Nurse Practitioner 363LF0000X 4704312027 MI
Family Nurse Practitioner 363LF0000X APRN001646 NV Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.13011 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11026902 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X L8-0010887 DE
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024194388 VA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 123875 WV
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.033023 IL

Addresses

Primary practice location

485 Blacklick Rd
Millersport, OH 43046-9725

Mailing address

885 3Rd Ave
New York, NY 10022-4834
Phone (855) 766-3760

Other identifiers 1

IdentifierTypeStateIssuer
0136163MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20130917000288 OH Practitioner - Nurse Practitioner 8426292285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brightside Health IncGroup PAC ID 9234525098, 213 clinicians

Practice addresses (Care Compare)

Columbus, OH 43212
Phone (415) 360-3348

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP7391AZMDFamily Nurse Practitioner
4704312027MIMDFamily Nurse Practitioner
APRN001646NVMDFamily Nurse Practitioner
COA.13011-NPOHMDFamily Nurse Practitioner
L8-0010887DEMDPsychiatric/Mental Health Nurse Practitioner
APRN11026902FLMDPsychiatric/Mental Health Nurse Practitioner
209.033023ILMDPsychiatric/Mental Health Nurse Practitioner
0024194388VAMDPsychiatric/Mental Health Nurse Practitioner
123875WVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Urgent Care Past 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, 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": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1669732624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100224834",
            "telephone_number": "855-766-3760",
            "fax_number": "855-766-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 BLACKLICK RD",
            "city": "MILLERSPORT",
            "state": "OH",
            "postal_code": "430469725",
            "telephone_number": "740-504-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ELIZABETH",
        "middle_name": "E",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "COA.13011-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11026902",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP7391",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704312027",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN001646",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.13011",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11026902",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0010887",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024194388",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WV",
            "license": "123875",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.033023",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136163",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Millersport, OH

Sources for this page

Verify at the official NPI Registry.