Davina L George, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

2016035063 Issued in MO

Practice address

12380 Depaul Drive
Bridgeton, MO 63044

NPI assigned

Jun 14, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1710417571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 FM 1960 RD W STE 230",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903024",
            "telephone_number": "877-749-7428",
            "fax_number": "512-628-3314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12380 DEPAUL DRIVE",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "63044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "DAVINA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2016035063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Damion T. Gatewood
• Mercy Nyandia Gathu
• Megan M Gau, MD
• Heather Christine Gay, BA
• George Dermatology, LLC
• Ramis Gheith, M.D.
• Gibson White Drake LLC (Jewel House)
• Raziya Gibson
• Gilmore Chiropractic & Health Services LLC
• Heather B Gilmore, DC, ATC

• Gerontology Nurse Practitioner in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Gerontology Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.