Individual provider Active NPI

Alexis Davis, NNP-BC

  • Critical Care Neonatal Nurse Practitioner
  • Towson, MD
National Provider Identifier
1770255143
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
AC005523 Issued in MD
Practice address
7601 Osler Dr
Towson, MD 21204-7700
Phone
(410) 337-1150
NPI assigned
Oct 4, 2021
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X 0024182784 VA
Critical Care Neonatal Nurse Practitioner 363LN0005X AC005523 MD Primary

Addresses

Primary practice location

7601 Osler Dr
Towson, MD 21204-7700

Mailing address

9 Woody Cir
Hampton, VA 23669-1653
Phone (757) 660-3833

Other practice location 1

601 Childrens Ln
Norfolk, VA 23507-1971
Phone (757) 660-3833

Other identifiers 3

IdentifierTypeStateIssuer
0024182784OtherVANNP LICENSE - STATE BOARD OF NURSING
104731431OtherVANCC
0001252030OtherVARN LICENSE - STATE BOARD OF NURSING

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230802004329 VA Practitioner - Nurse Practitioner 7618338906 Reassigns benefits to 1 organization
I20230822002987 MD Practitioner - Nurse Practitioner 7618338906 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024182784VAMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Jul 8, 2023 Accepting new patients
Childrens Specialty Group PLLC CurrentSince Jul 1, 2023 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Jul 8, 2023 Accepting new patients

Locations

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

Interoperability endpoints

  • Direct secure messaging: adavis616730@direct.healthsystem.virginia.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1770255143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WOODY CIR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236691653",
            "telephone_number": "757-660-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 OSLER DR",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047700",
            "telephone_number": "410-337-1150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Childrens Ln",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071971",
            "country_code": "US",
            "telephone_number": "757-660-3833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ALEXIS",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "VA",
            "license": "0024182784",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "MD",
            "license": "AC005523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NNP LICENSE - STATE BOARD OF NURSING",
            "identifier": "0024182784",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCC",
            "identifier": "104731431",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE - STATE BOARD OF NURSING",
            "identifier": "0001252030",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.