Individual provider Active NPI

Eleanor Sharon Davis, CNM

  • Advanced Practice Midwife
  • Albany, GA
National Provider Identifier
1700879244
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
R076668 Issued in GA
Practice address
2701 Meredyth Dr
Albany, GA 31707-2267
Phone
(229) 883-7010
Fax
(229) 430-9220
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice MidwifeGroup: 193200000X MULTI-SPECIALTY GROUP 367A00000X
Advanced Practice Midwife 367A00000X R076668 GA Primary

Addresses

Primary practice location

2701 Meredyth Dr
Albany, GA 31707-2267

Mailing address

2701 Meredyth Dr
Albany, GA 31707-2267
Phone (229) 883-7010

Other identifiers 1

IdentifierTypeStateIssuer
618956236AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041209000788 GA Practitioner - Certified Nurse Midwife (CNM) 7315903481 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Veranda, PCGroup PAC ID 3173595477, 6 clinicians
Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

2701 Meredyth Dr
Albany, GA 31707-2267
Phone (229) 883-7010

Hospital & facility affiliations

  • Phoebe Putney Memorial Hospital Hospital, Albany, GA, CCN 110007
  • Phoebe Sumter Medical Center Hospital, Americus, GA, CCN 110044

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R076668GAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
The Veranda, PC Multi-Specialty CurrentSince Jan 1, 1999 Accepting new patients

Locations

2701 Meredyth Dr
Albany, GA 31707
Phone (229) 883-7010

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: eleanor.davis.1@8042.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1700879244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 MEREDYTH DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317072267",
            "telephone_number": "229-883-7010",
            "fax_number": "229-430-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 MEREDYTH DR",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317072267",
            "telephone_number": "229-883-7010",
            "fax_number": "229-430-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ELEANOR",
        "middle_name": "SHARON",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "R076668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "618956236A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.