Individual provider Active NPI

Holly K Davis, NP-C

  • Nurse Practitioner
  • Cordele, GA
National Provider Identifier
1790048023
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN-NP169913 Issued in GA
Practice address
712 N 7TH St
Cordele, GA 31015-3271
Phone
(229) 276-0052
Fax
(229) 276-0064
NPI assigned
Jun 21, 2012
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 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 APRN-NP169913 GA Primary

Addresses

Primary practice location

712 N 7TH St
Cordele, GA 31015-3271

Mailing address

712 N 7TH St
Cordele, GA 31015-3271
Phone (229) 276-0052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20120803000092 GA Practitioner - Nurse Practitioner 0941456149 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN-NP169913GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Hospice, Inc Current Accepting new patients
Careconnect Health, Inc. CurrentSince Jul 29, 2016 Accepting new patients
Pruitthealth Hospice, Inc. CurrentSince Nov 14, 2020 Accepting new patients
Careconnect Health, Inc. CurrentSince Jul 29, 2016 Accepting new patients
Pruitthealth Hospice, Inc. CurrentSince Nov 14, 2020 Accepting new patients
Careconnect Health, Inc. Past Accepting new patients
Plains Medical Center, Inc, Past Accepting new patients

Locations

708 E 16th Ave
Cordele, GA 31015
Phone (229) 271-0300

712 N 7th St
Cordele, GA 31015
Phone (229) 276-0052

6060 Lakeside Commons Dr
Macon, GA 31210
Phone (478) 745-9204

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

510 Alston St
Ste B
Richland, GA 31825
Phone (229) 887-3324

Organizations & group practices 7

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": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1790048023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 N 7TH ST",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153271",
            "telephone_number": "229-276-0052",
            "fax_number": "229-276-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 N 7TH ST",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153271",
            "telephone_number": "229-276-0052",
            "fax_number": "229-276-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "HOLLY",
        "middle_name": "K",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "APRN-NP169913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordele, GA

Sources for this page

Verify at the official NPI Registry.