Active NPI
Jasmine Sharee Davis
- Psychiatric/Mental Health Nurse Practitioner
- De Soto, IL
National Provider Identifier
1801764907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 209033596
- Practice address
- 90 Jan LN
De Soto, IL 62924-0059 - Phone
- (618) 645-1211
- NPI assigned
- Oct 29, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 209033596 | IL | Primary |
Addresses
Primary practice location
90 Jan LN
De Soto, IL 62924-0059
Mailing address
90 Jan LN
De Soto, IL 62924-0059
Phone (618) 645-1211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1203 W Augusta Blvd
Suite 1
Chicago, IL 60642-4327
Phone (773) 248-2255
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209033596 | IL | MD | Psychiatric/Mental Health Nurse Practitioner |
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 and National Provider Directory roles.
-
- Psychiatry Physician
- Chicago, IL
- NPI 1952937104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774569600000",
"number": "1801764907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 JAN LN",
"city": "DE SOTO",
"state": "IL",
"postal_code": "629240059",
"telephone_number": "618-645-1211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 JAN LN",
"city": "DE SOTO",
"state": "IL",
"postal_code": "629240059",
"telephone_number": "618-645-1211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JASMINE",
"middle_name": "SHAREE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-10-29",
"last_updated": "2026-03-27",
"certification_date": "2026-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IL",
"license": "209033596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in De Soto, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; 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.