Individual provider Active NPI

Amanda Marie Davis, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1700401908
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
213735 Issued in LA
Practice address
2751 Albert L Bicknell Dr Ste 5C
Shreveport, LA 71103-3943
Phone
(318) 227-9777
NPI assigned
Jun 12, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 213735 LA
Acute Care Nurse Practitioner 363LA2100X 213735 LA Primary
Nurse Practitioner 363L00000X 213735 LA

Addresses

Primary practice location

2751 Albert L Bicknell Dr Ste 5C
Shreveport, LA 71103-3943

Mailing address

2751 Albert L Bicknell Dr Ste 5C
Shreveport, LA 71103-3943
Phone (318) 227-9777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20210303001413 LA Practitioner - Nurse Practitioner 8820404684 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Red River Cardiovascular SurgeonsGroup PAC ID 0941363493, 7 clinicians

Practice addresses (Care Compare)

2751 Albert L Bicknell Dr
Suite 5C
Shreveport, LA 71103-3943
Phone (318) 227-9777

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213735LAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Louisiana Physicians, LLC Nurse Practitioner CurrentSince Mar 23, 2024 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Apr 3, 2023 Accepting new patients
Northwest Louisiana Intensivists LLC Nurse Practitioner CurrentSince Mar 1, 2025 Accepting new patients
WK Red River Cardiovascular Surgeons CurrentSince Nov 28, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Apr 3, 2023 Accepting new patients

Locations

2531 Viking Dr
Bossier City, LA 71111
Phone (318) 681-7000

2751 Albert L Bicknell Dr
Ste 5C
Shreveport, LA 71103
Phone (318) 227-9777

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138

Organizations & group practices 5

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 4

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": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1700401908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR STE 5C",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033943",
            "telephone_number": "318-227-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 ALBERT L BICKNELL DR STE 5C",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033943",
            "telephone_number": "318-227-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-12",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "213735",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "213735",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "213735",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.