Diane M Privitor Davis, FNP-C, PMHNPBC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APO5002 Issued in LA

Practice address

1501 Stubbs Ave
Monroe, LA 71201-7120

Phone

(318) 816-5116

Fax

(318) 855-3429

NPI assigned

Sep 26, 2006

Last updated

Jul 7, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 LA

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

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Therapeutic Medical and Psychiatric Services LLCGroup PAC ID 8022294776, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ddavis@tmapsl-la.direct.office.nextgen.com

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.

• Therapeutic Medical & Psychiatric Services LLC.

  • Psychiatric/Mental Health Nurse Practitioner
  • Monroe, LA
  • NPI 1750672390
  Medicare reassignment Care Compare group
• Rhonda Terese Rushing LLC

  dba Rhonda Rushing PMHNPBC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Monroe, LA
  • NPI 1184200297
  NPD
• Affinity Health Group, LLC

  dba Oliver Road Family Practice

  • Family Medicine Physician
  • Monroe, LA
  • NPI 1609267897
  NPD (past)
• Oliver Road Medical Clinic LLC

  • Family Medicine Physician
  • Monroe, LA
  • NPI 1639356181
  NPD (past)
• Solutions Medical Consulting, LLC

  dba Serenity Springs Specialty Hospital

  • Psychiatric Hospital
  • Ruston, LA
  • NPI 1720025919
  NPD (past)
• Solutions Medical Consulting, LLC

  dba Serenity Springs Specialty Hospital

  • Psychiatric Hospital
  • Ruston, LA
  • NPI 1861693962

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1891886024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WINTERPARK DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712921106",
            "telephone_number": "318-509-8008",
            "fax_number": "318-329-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 STUBBS AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017120",
            "telephone_number": "318-816-5116",
            "fax_number": "318-855-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIVITOR DAVIS",
        "first_name": "DIANE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP-C, PMHNPBC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP05002",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "APO5002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primary Health Services Center (PHSC S D Hill Clinic)
• Prime Minds Therapy and Beyond, LLC
• Lashunta Pringle, MB
• Melodynee Pringle, MB
• Brittany Pritchard
• Gwendolyn Holdiness Proctor, MD
• Michael Proctor
• Professional Care Pharmacy, LLC
• Progressive Healthcare (Monroe Medical Clinic)
• Prohealth Monroe LLC

• Psychiatric/Mental Health Nurse Practitioner in Monroe, LA
• Providers in Monroe, LA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.