Passionate Shinese Davis, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

30367 Issued in TN

Practice address

509 N Cedar Ave
Cookeville, TN 38501-1707

Phone

(931) 520-8435

Fax

(931) 372-7225

NPI assigned

Feb 26, 2024

Last updated

Feb 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Personal Development Center, Inc.Group PAC ID 5496768855, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Personal Development Center, Inc.

  dba Personal Growth and Learning Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cookeville, TN
  • NPI 1942324884
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1801652888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 NEWPORT CIR",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370757115",
            "telephone_number": "901-337-4464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N CEDAR AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011707",
            "telephone_number": "931-520-8435",
            "fax_number": "931-372-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "PASSIONATE",
        "middle_name": "SHINESE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "30367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Williams Davis, MD
• Jennifer B Davis, PHARM.D.
• Justin Davis, PMHNP
• McKenzie Brooke Davis, PA-C
• Miranda Kathleen Davis, RBT
• Zachary Boyd Davis
• Mallory Dawson, DMD
• Sara Iris Debovis, NP
• Chelsea Delk, APRN
• Christopher Delk

• Psychiatric/Mental Health Nurse Practitioner in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; 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.