Active NPI
Bethann H Davis, NP
- Adult Health Nurse Practitioner
- Braintree, MA
National Provider Identifier
1871563361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 194673
- Practice address
- 759 Granite St
South Shore Health Center
Braintree, MA 02184 - Phone
- (781) 848-1950
- Fax
- (781) 356-4887
- NPI assigned
- Jan 25, 2006
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 194673 | MA | Primary |
Addresses
Primary practice location
759 Granite St
South Shore Health Center
Braintree, MA 02184
Mailing address
759 Granite St
South Shore Health Center
Braintree, MA 02184
Phone (781) 848-1950
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP9770 | Other | MA | BCBSMA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 194673 | MA | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jordan Physician Associates, Inc. | Past | Accepting new patients |
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.
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- Plymouth, MA
- NPI 1194263186
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193616000000",
"number": "1871563361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "759 GRANITE ST",
"address_2": "SOUTH SHORE HEALTH CENTER",
"city": "BRAINTREE",
"state": "MA",
"postal_code": "02184",
"telephone_number": "781-848-1950",
"fax_number": "781-356-4887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "759 GRANITE ST",
"address_2": "SOUTH SHORE HEALTH CENTER",
"city": "BRAINTREE",
"state": "MA",
"postal_code": "02184",
"telephone_number": "781-848-1950",
"fax_number": "781-356-4887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "BETHANN",
"middle_name": "H",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-25",
"last_updated": "2007-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "MA",
"license": "194673",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSMA",
"identifier": "NP9770",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Braintree, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.