Active NPI
Elizabeth Kristin Davis, PA-C
- Physician Assistant
- Fayetteville, NC
National Provider Identifier
1710846431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-16157
- Practice address
- 1638 Owen Dr
Fayetteville, NC 28304-3424 - Phone
- (910) 615-5590
- NPI assigned
- Jan 19, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | 0010-16157 | NC | |
| Physician Assistant | 363A00000X | 0010-16157 | NC | Primary |
Addresses
Primary practice location
1638 Owen Dr
Fayetteville, NC 28304-3424
Mailing address
1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1 Zotec Way
Carmel, IN 46032-0052
PO Box
Suite 40908
Fayetteville, NC 28309
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-16157 | NC | MD | Physician Assistant |
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.
-
- Emergency Medicine Physician
- Fayetteville, NC
- NPI 1215931589
-
- Hematology & Oncology Physician
- Fayetteville, NC
- NPI 1881946242
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1768780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775433600000",
"number": "1710846431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1638 OWEN DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043424",
"telephone_number": "910-615-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1638 OWEN DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043424",
"telephone_number": "910-615-5590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ELIZABETH",
"middle_name": "KRISTIN",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-01-19",
"last_updated": "2026-04-06",
"certification_date": "2026-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0204X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "NC",
"license": "0010-16157",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-16157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.