Individual provider Active NPI

Jessica Davis

  • Family Nurse Practitioner
  • Middletown, OH
National Provider Identifier
1952091100
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0033473 Issued in OH
Practice address
200 Medical Center Dr Ste 375
Middletown, OH 45005-5180
Phone
(513) 420-3773
NPI assigned
May 10, 2023
Last updated
May 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0033473 OH Primary

Addresses

Primary practice location

200 Medical Center Dr Ste 375
Middletown, OH 45005-5180

Mailing address

3772 Grant Ave Unit G
Beavercreek, OH 45431-2098
Phone (251) 725-3015

Other practice location 1

2400 Miami Valley Dr Ste 160
Centerville, OH 45459-4774
Phone (937) 312-1661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20230721002542 OH Practitioner - Nurse Practitioner 6800256868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

200 Medical Ctr Dr
Suite 375
Middletown, OH 45005-5180
Phone (937) 208-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
66.25
Promoting interoperability
100
Improvement activities
40
Cost
71.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0033473OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc Current Accepting new patients
Premier Health Specialists Inc CurrentSince Jun 26, 2023 Accepting new patients
Premier Health Specialists Inc CurrentSince Jun 26, 2023 Accepting new patients
Premier Heart Associates, Inc Past Accepting new patients

Locations

2400 Miami Valley Dr
Ste 160
Centerville, OH 45459
Phone (937) 312-1661

30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300

200 Medical Center Dr
Ste 375
Middletown, OH 45005
Phone (513) 420-3773

3170 Kettering Blvd
Bldg 2
Moraine, OH 45439

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1952091100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3772 GRANT AVE UNIT G",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312098",
            "telephone_number": "251-725-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL CENTER DR STE 375",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450055180",
            "telephone_number": "513-420-3773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Miami Valley Dr Ste 160",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454594774",
            "country_code": "US",
            "telephone_number": "937-312-1661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0033473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.