Lorene Davis, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Vidalia, GA
NPI 1922468263 · NPPES record last updated Oct 16, 2025
Key facts
- NPI
- 1922468263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN163933 (GA)
- Practice address
- 118 Alice Coleman Dr
Vidalia, GA 30474-8860 - Phone
- (912) 537-6565
- NPI assigned
- Feb 29, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161102002204 | GA | Practitioner - Nurse Practitioner | 3476831074 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP3293502 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Georgia Healthcare Center, Inc. | Current | Accepting new patients | |
| East Georgia Healthcare Center, Inc. | Current | Accepting new patients |
Locations
117 Memorial Dr
Reidsville, GA 30453
Phone (912) 557-3300
215 N Coleman St
Swainsboro, GA 30401
Phone (478) 237-2638
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FBFFAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN163933 | GA | Yes |
| Family Nurse Practitioner | 363LF0000X | ARNP3293502 | FL |
Addresses
Primary practice location
118 Alice Coleman Dr
Vidalia, GA 30474-8860
Mailing address
118 Alice Coleman Dr
Vidalia, GA 30474-8860
Phone (912) 537-6565
Other providers in Vidalia, GA
- Damostamazing LLC
- Darel C. Edwards, P.C.
- Daniel Lauren Dasher
- David S. Edmonds OD PC
- Bartlett Emory Davis
- Cassey Deardorf-Snow
- Deborah K Deloach
- Dental Center of Vidalia
- John Burton Derrick
- Melania B. Domingo
All providers in Vidalia, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.