Ebony Nicole Davis, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN076466 Issued in GA

Practice address

169 Parkview Rd
Savannah, GA 31419-9671

Phone

(912) 677-8231

Fax

(888) 494-4209

NPI assigned

Aug 19, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ebony Healthcare Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Savannah, GA
  • NPI 1679196349

  Licensed Practical Nurse

  NPD

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1720635394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 PARKVIEW RD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314199671",
            "telephone_number": "912-677-8231",
            "fax_number": "888-494-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 PARKVIEW RD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314199671",
            "telephone_number": "912-677-8231",
            "fax_number": "888-494-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "EBONY",
        "middle_name": "NICOLE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN076466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPN STATE LICENSE",
            "identifier": "LPN076466",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dhylles Davis
• Diane Watkins Davis, M.D.
• Doris Ann Lynette Davis, APRN, AGPCNP-BC
• Doris Michelle Davis, BCBA PHD
• Drew Gregory Davis, M.D.
• Eric K Davis, MD
• Frank Etheridge Davis III, M.D.
• Haley Davis, PT, DPT
• Janalee Davis, M.D.
• Jaqueline Margaret Davis, NP

• Licensed Practical Nurse in Savannah, GA
• Providers in Savannah, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.