Active NPI
Dalton Cole Davis, BSN
- Critical Care Medicine Registered Nurse
- Jacksonville, FL
National Provider Identifier
1740878875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- 324571
- Practice address
- 800 Prudential Dr
Jacksonville, FL 32207-8202 - Phone
- (904) 202-2000
- NPI assigned
- Jan 5, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 324571 | NC | Primary |
Addresses
Primary practice location
800 Prudential Dr
Jacksonville, FL 32207-8202
Mailing address
3800 Joe Ashton Rd
St Augustine, FL 32092-2518
Phone (904) 501-4493
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 324571 | NC | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609804800000",
"number": "1740878875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 JOE ASHTON RD",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320922518",
"telephone_number": "904-501-4493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 PRUDENTIAL DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078202",
"telephone_number": "904-202-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DALTON",
"middle_name": "COLE",
"name_prefix": "Mr.",
"credential": "BSN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-05",
"last_updated": "2021-01-05",
"certification_date": "2021-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "NC",
"license": "324571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.