Active NPI
Candice R Davis, MSN, NP-C, APRN, BC
- Family Nurse Practitioner
- Cleveland, OH
National Provider Identifier
1689602302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- NP-08864
- Practice address
- 2500 Metrohealth Dr
Room a-109
Cleveland, OH 44109-1900 - Phone
- (216) 778-7800
- NPI assigned
- Jun 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN-302572 | OH | |
| Family Nurse Practitioner | 363LF0000X | NP-08864 | OH | Primary |
Addresses
Primary practice location
2500 Metrohealth Dr
Room a-109
Cleveland, OH 44109-1900
Mailing address
150 Dover Rd
Pittsboro, NC 27312
Phone (440) 241-8012
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2666020 | Medicaid | OH |
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
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN-302572 | OH | MD | Registered Nurse |
| NP-08864 | OH | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216684800000",
"number": "1689602302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 DOVER RD",
"city": "PITTSBORO",
"state": "NC",
"postal_code": "27312",
"telephone_number": "440-241-8012"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 METROHEALTH DR",
"address_2": "ROOM A-109",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441091900",
"telephone_number": "216-778-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "CANDICE",
"middle_name": "R",
"name_prefix": "Ms.",
"credential": "MSN, NP-C, APRN, BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-29",
"last_updated": "2008-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN-302572",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "NP-08864",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2666020",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.