Individual provider Active NPI

Romanyne Roshan Davis, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Lake Worth, FL
National Provider Identifier
1841663424
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP 9235535 Issued in FL
Practice address
4743 Clemens St
Lake Worth, FL 33463-8702
Phone
(561) 255-2509
NPI assigned
Nov 4, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP 9235535 FL Primary

Addresses

Primary practice location

4743 Clemens St
Lake Worth, FL 33463-8702

Mailing address

4743 Clemens St
Lake Worth, FL 33463-8702
Phone (561) 255-2509

Other names 1

  • Romanyne Roshan Nain Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160525002697 FL Practitioner - Nurse Practitioner 2264722651 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 9235535FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph L Morse Health Center, Inc. CurrentSince Dec 21, 2015 Accepting new patients
Joseph L Morse Health Center, Inc. CurrentSince Dec 21, 2015 Accepting new patients

Locations

4847 David S Mack Dr
West Palm Beach, FL 33417
Phone (561) 209-6123

Interoperability endpoints

  • Direct secure messaging: rdavis19631@jupitermedicalcenter.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1841663424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4743 CLEMENS ST",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334638702",
            "telephone_number": "561-255-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4743 CLEMENS ST",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334638702",
            "telephone_number": "561-255-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ROMANYNE",
        "middle_name": "ROSHAN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 9235535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROMANYNE",
            "last_name": "NAIN",
            "middle_name": "ROSHAN",
            "credential": "NURSE PRACTITIONER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.