Vethilla Davis

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN254248 Issued in GA

Practice address

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031

Phone

(404) 616-4781

NPI assigned

May 7, 2019

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

• Vethilla Hairston Former name

Medicare fee-for-service enrollment

Enrolled in GA

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

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 and National Provider Directory roles.

• Chronic Disease Management of Georgia, LLC

  • Physical Medicine & Rehabilitation Physician
  • Monroe, GA
  • NPI 1699300939

  Psychiatric/Mental Health

  Medicare reassignment NPD
• TMC-Behavioral Health of West Georgia

  • Geriatric Psychiatry Physician
  • Villa Rica, GA
  • NPI 1356795462
  NPD

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557187200000",
    "number": "1851956791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HERRELL RD",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301805527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 JESSE HILL JR DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303033031",
            "telephone_number": "404-616-4781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Herrell Rd",
            "address_purpose": "LOCATION",
            "city": "Villa Rica",
            "state": "GA",
            "postal_code": "301805527",
            "country_code": "US",
            "telephone_number": "770-812-3266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "VETHILLA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2019-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "GA",
            "license": "RN254248",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN254248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VETHILLA",
            "last_name": "HAIRSTON",
            "credential": "MSN, PMHNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffanie L Davis, LPC
• Timothy E Davis, MD
• Timothy Michael Davis, RN
• Todd C. Davis, DDS
• Todd Ware Davis, MD
• Willette Christine Davis, MD
• Yolanda Davis
• Yvonne Davis, LCSW
• Sarena Davison-Rodgers
• Mark Davison, MD

• Psychiatric/Mental Health Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.