Individual provider Active NPI

Sharon Renae Davis, FNP - BC

  • Nurse Practitioner
  • Goodyear, AZ
National Provider Identifier
1790036689
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
316758 Issued in AZ
Practice address
18440 W Wind Song Ave
Goodyear, AZ 85338-2629
Phone
(801) 450-8403
NPI assigned
Oct 2, 2012
Last updated
Aug 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 316758 AZ Primary

Addresses

Primary practice location

18440 W Wind Song Ave
Goodyear, AZ 85338-2629

Mailing address

18440 W Wind Song Ave
Goodyear, AZ 85338-2629
Phone (801) 450-8403

Other names 1

  • Ms. Sharon Renae Atkin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20251125004456 AZ Practitioner - Nurse Practitioner 4789087511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

80 Arkay Dr
Hauppauge, NY 11788-3705

80 Arkay Dr
Suite 230
Hauppauge, NY 11788-3728

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
316758AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upward Health of Arizona LLC CurrentSince Aug 29, 2025 Accepting new patients

Locations

80 Arkay Dr
Ste 230
Hauppauge, NY 11788
Phone (631) 540-8225

Interoperability endpoints

  • Direct secure messaging: sharon.davis.1@15578.direct.athenahealth.com

Organizations & group practices 1

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": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1790036689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18440 W WIND SONG AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382629",
            "telephone_number": "801-450-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18440 W WIND SONG AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853382629",
            "telephone_number": "801-450-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHARON",
        "middle_name": "RENAE",
        "name_prefix": "Mrs.",
        "credential": "FNP - BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "316758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "ATKIN",
            "middle_name": "RENAE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Goodyear, AZ

Sources for this page

Verify at the official NPI Registry.