Jennifer Dawn Davis, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN104154 Issued in LA

Practice address

213 Joe Mac Dr
Stonewall, LA 71078-2837

Phone

(318) 347-7415

NPI assigned

Aug 17, 2023

Last updated

Sep 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 LA

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Robert Marriott Medical CorpGroup PAC ID 2567531494, 63 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Robert Marriott Medical Corp

  dba Advantage Wound Care

  • Surgery Physician
  • El Segundo, CA
  • NPI 1083883938

  LA, Single Specialty

  Medicare reassignment Care Compare group NPD
• Robert Marriott Medical Corp

  • Surgery Physician
  • Lafayette, LA
  • NPI 1093266553
  NPD

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1831972314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 JOE MAC DR",
            "city": "STONEWALL",
            "state": "LA",
            "postal_code": "710782837",
            "telephone_number": "318-347-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 JOE MAC DR",
            "city": "STONEWALL",
            "state": "LA",
            "postal_code": "710782837",
            "telephone_number": "318-347-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JENNIFER",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-17",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN104154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Council for Advancement of Social Service and Education
• Brandon T Craig, DPT
• Credit Angel Transportation
• Emily Carol Ryan Cristler, PT
• D N L Outpatient Rehab, LLC
• Larry Davis
• Katherine Deporter
• Desoto Physical Therapy, L.L.C.
• Janet Dodson
• Amanda Sims Dominguez, PHARM D.

• Family Nurse Practitioner in Stonewall, LA
• Providers in Stonewall, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.