Clinton L Davis, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1-126214 Issued in AL

Practice address

1815 Hand Ave
Bay Minette, AL 36507

Phone

(251) 937-5521

NPI assigned

Sep 13, 2019

Last updated

Sep 13, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urgent Care 59 PCGroup PAC ID 6002274925, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cdavis83639@directinfirmaryhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Urgent Care 59, PC

  • Rural Health Clinic/Center
  • Bay Minette, AL
  • NPI 1093415671
  Medicare reassignment Care Compare group NPD
• Imc-Eastern Shore Adult Medicine, LLC

  • Internal Medicine Physician
  • Fairhope, AL
  • NPI 1912284852
  Medicare reassignment NPD
• Imc-Emergency Physicians LLC

  • Emergency Medicine Physician
  • Bay Minette, AL
  • NPI 1578048278
  Medicare reassignment NPD
• Imc-Hospitalists LLC

  • Hospitalist Physician
  • Mobile, AL
  • NPI 1669824934
  Medicare reassignment NPD

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

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1760032510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 MOOG AVENUE",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "36507",
            "telephone_number": "251-979-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 HAND AVE",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "36507",
            "telephone_number": "251-937-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CLINTON",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-13",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-126214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "cld_2k@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "1815 Hand Ave",
            "city": "Bay Minette",
            "state": "AL",
            "country_code": "US",
            "postal_code": "36507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Acute Care Nurse Practitioner in Bay Minette, AL
• Providers in Bay Minette, AL by specialty
• Acute Care Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; 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.

Verify at the official NPI Registry.