Damon Davis, AHCNS

Primary specialty

Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X

License

2009033936 Issued in MO

Practice address

3100 Warrior LN
Poplar Bluff, MO 63901-8686

Phone

(573) 727-9311

Fax

(573) 785-0182

NPI assigned

Nov 19, 2009

Last updated

Jul 31, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Certified Clinical Nurse Specialist (CNS)

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

19.83 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

66.1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gibbs Wound Care LLC

  • Critical Care Medicine Nurse Practitioner
  • Poplar Bluff, MO
  • NPI 1902279110
  Medicare reassignment NPD
• Mobile Wound Care Solutions LLC

  • Specialist
  • Cincinnati, OH
  • NPI 1548070014

  MO

  Medicare reassignment NPD
• Regional Healthcare Group LLC

  • Acute Care Nurse Practitioner
  • Mount Juliet, TN
  • NPI 1407587363

  MO

  Medicare reassignment NPD

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1699003210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1269 COUNTY ROAD 468",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012989",
            "telephone_number": "573-778-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 WARRIOR LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639018686",
            "telephone_number": "573-727-9311",
            "fax_number": "573-785-0182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DAMON",
        "credential": "AHCNS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-19",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "MO",
            "license": "2009033936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary W Dausmann, MD
• Reeca Daves, D.D.S.
• Regina Lynn Davidson
• Andrew C.F. Davis-Cole, FNP
• Alicia Davis
• Darwin L Davis Jr., M.D.
• Emily Davis
• Jacie Davis, LCSW
• Ryan Davis
• Sydney Davis

• Adult Health Clinical Nurse Specialist in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Adult Health Clinical Nurse Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.