Alexander Stein Davis, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2021004960 Issued in MO

Practice address

2650 Olive St
Saint Louis, MO 63103-1489

Phone

(314) 371-6500

Fax

(314) 371-6510

NPI assigned

Mar 4, 2021

Last updated

Oct 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Saint Louis University School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Provident IncGroup PAC ID 0345217279, 19 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.

• Provident Inc.

  dba Provident Behavioral Health

  • Mental Health Counselor
  • Saint Louis, MO
  • NPI 1710023791

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1881289510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031489",
            "telephone_number": "314-371-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631031489",
            "telephone_number": "314-371-6500",
            "fax_number": "314-371-6510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11222 Tesson Ferry Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631236963",
            "country_code": "US",
            "telephone_number": "314-898-0102",
            "fax_number": "314-842-2552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ALEXANDER",
        "middle_name": "STEIN",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-04",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2021004960",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2021004960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Davis Reliable Home Healthcare Agency (Healing Waters of St Louis LLC)
• Cheryl Davis-Brooks
• Chaunta S Davis-Gibbs, CNA
• Christina Dawn Davis-Stellwag
• Albert Augustus Davis, MD
• Amy Davis
• Amy L Davis, NP
• Andrea Elena Davis, MD
• Andrew Ryan Davis, M.D.
• Andrew Tyler Davis, MD

• Psychiatric/Mental Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Psychiatric/Mental Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; 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.