Amanda Blake Davis, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A0053338 Issued in AR

Practice address

3416 Old Greenwood Rd
Fort Smith, AR 72903-5462

Phone

(479) 242-2888

Fax

(479) 242-2889

NPI assigned

Dec 21, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amanda Richard Former name

Medicare fee-for-service enrollment

Enrolled in AR

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Arkansas Liver and Gastroenterology PAGroup PAC ID 1557672409, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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

• Arkansas Liver and Gastroenterology PA

  • Clinic/Center
  • Fort Smith, AR
  • NPI 1932586260
  Medicare reassignment Care Compare group
• Cisterna Emergency Physicians LLC

  • Emergency Medicine Physician
  • Fort Smith, AR
  • NPI 1306178371
  NPD (past)
• WH Ar Medical PLLC

  • Family Medicine Physician
  • Springdale, AR
  • NPI 1235861147
  NPD (past)

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1790220143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 PARKRIDGE DR",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729567491",
            "telephone_number": "479-226-0979",
            "fax_number": "479-242-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3416 OLD GREENWOOD RD",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035462",
            "telephone_number": "479-242-2888",
            "fax_number": "479-242-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AMANDA",
        "middle_name": "BLAKE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "118856",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A0053338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "RICHARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terri Dart, PHARMD
• Prithi Dathi, MD
• Jennifer Elaine Davenport, APN
• Alesia J Davis, APRN
• Alexis Elizabeth Davis
• Barbara Davis, LPC
• Celeste Davis, PHARMD
• David Davis, CRNA
• Gregory W Davis, MD
• Jennifer Davis, LPC

• Family Nurse Practitioner in Fort Smith, AR
• Providers in Fort Smith, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.