Individual provider Active NPI

Ashley Dawn Davis

  • Psychiatric/Mental Health Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1942189972
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
39767 Issued in TN
Practice address
112 Merman Rd
Kingsport, TN 37663-3446
Phone
(423) 361-0202
NPI assigned
Sep 2, 2025
Last updated
Oct 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 39767 TN Primary

Addresses

Primary practice location

112 Merman Rd
Kingsport, TN 37663-3446

Mailing address

112 Merman Rd
Kingsport, TN 37663-3446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20251125003680 TN Practitioner - Nurse Practitioner 4385136456 Reassigns benefits to 2 organizations
I20260514000896 IA Practitioner - Nurse Practitioner 4385136456 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SBH-KingsportGroup PAC ID 8325399256, 10 clinicians
SBH-Davenport LLCGroup PAC ID 1759702756, 11 clinicians

Practice addresses (Care Compare)

1025 Executive Park Blvd
Kingsport, TN 37660-4620
Phone (423) 830-8110

770 Tanglefoot LN
Bettendorf, IA 52722-1608
Phone (563) 396-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SBH-Kingsport CurrentSince Nov 6, 2025 Accepting new patients
Medpsych Inc. PC CurrentSince Feb 3, 2026 Accepting new patients
SBH-Kingsport CurrentSince Nov 6, 2025 Accepting new patients

Locations

770 Tanglefoot Ln
Bettendorf, IA 52722
Phone (563) 241-7443

1025 Executive Park Blvd
Kingsport, TN 37660
Phone (423) 765-0777

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1756771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1942189972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MERMAN RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MERMAN RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376633446",
            "telephone_number": "423-361-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ASHLEY",
        "middle_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-02",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "39767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.