Jessica Rae Davis, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

6900 Alden Dr BLDG 160
Fe Warren Afb, WY 82005-2945

Phone

(307) 773-3040

NPI assigned

Sep 9, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1861827990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6331 MAIN ST UNIT A",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820093479",
            "telephone_number": "343-233-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 ALDEN DR BLDG 160",
            "city": "FE WARREN AFB",
            "state": "WY",
            "postal_code": "820052945",
            "telephone_number": "307-773-3040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Truemper St Bldg 6612",
            "address_purpose": "LOCATION",
            "city": "Lackland AFB",
            "state": "TX",
            "postal_code": "782365583",
            "country_code": "US",
            "telephone_number": "210-671-9736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JESSICA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-09",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Ryan Berg, D.O.
• Elizabeth Buss, DPT
• Julie Ann Carpenter, PHARMD
• Joseph Gregory Coles, M.D.
• Carrie Cravens, LSCW
• Dod Fe Warren Pharmacy
• Barbara Bridget Eakin, RN
• Emilie Lenora Elick, PSYD
• Earl H Faulkner, PHD
• Fe Warren Medical Group

• Physician Assistant in Fe Warren Afb, WY
• Providers in Fe Warren Afb, WY by specialty
• Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.