Gwendolyn Davis

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A004882 Issued in AR

Practice address

626 Poplar St
Helena, AR 72342-3140

Phone

(870) 338-8163

Fax

(870) 338-7810

NPI assigned

Dec 5, 2016

Sex

Female

Sole proprietor

No

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 AR

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gkdavis@yourcarecommunity.org
• Direct secure messaging: gwendolyn.davis.1@27024.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/27024/brand/1/csg/1/fhir/r4

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.

• Bell Clinic P.a.

  • Rural Health Clinic/Center
  • Helena, AR
  • NPI 1306832845

  AR

  Medicare reassignment NPD
• Bell-Winstonclinic,P.a.

  • Rural Health Clinic/Center
  • Elaine, AR
  • NPI 1427044627
  NPD

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

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1700320173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 POPLAR ST",
            "city": "HELENA",
            "state": "AR",
            "postal_code": "723423140",
            "telephone_number": "870-338-8163",
            "fax_number": "870-338-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 POPLAR ST",
            "city": "HELENA",
            "state": "AR",
            "postal_code": "723423140",
            "telephone_number": "870-338-8163",
            "fax_number": "870-338-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "GWENDOLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-05",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crestpark Retirement Helena, LLC
• Cricket Dental PLLC
• Susan Von Daniel
• Shelley Renee Darby, OTR
• David Lee Webber D.O. P.a.
• Sabrina A Davis
• Vonadine Davis
• Dayspring Behavioral Health
• Deans Pharmacies, Inc.
• Delta Dermatology and Skin Cancer Specialists, P.a.

• Family Nurse Practitioner in Helena, AR
• Providers in Helena, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; 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.