Individual provider Active NPI

Zachary T Davis, MSN, APRN, CNP

  • Nurse Practitioner
  • Warren, OH
National Provider Identifier
1952640146
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN363464 Issued in OH
Practice address
349 Niles Cortland Rd NE
Warren, OH 44484-1976
Phone
(330) 372-0260
Fax
(330) 372-0261
NPI assigned
Feb 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA.14275NP OH
Family Nurse Practitioner 363LF0000X APRN.CNP.14275 OH
Nurse Practitioner 363L00000X RN363464 OH Primary

Addresses

Primary practice location

349 Niles Cortland Rd NE
Warren, OH 44484-1976

Mailing address

349 Niles Cortland Rd NE
Warren, OH 44484-1976
Phone (330) 372-0260

Other identifiers 1

IdentifierTypeStateIssuer
0081456MedicaidOH

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
I20130510000115 OH Practitioner - Nurse Practitioner 0244477297 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA.14275NPOHMDNurse Practitioner
RN363464OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Robert E. Bisel, DO & Associates, LLC CurrentSince Aug 1, 2019 Accepting new patients
Mahoning Valley Emergency Specialists LLC CurrentSince Apr 1, 2015 Accepting new patients
4M Hospitalist Services, LLC Nurse Practitioner CurrentSince Apr 12, 2016 Accepting new patients

Locations

29 N Adams St
Akron, OH 44304
Phone (330) 572-7293

3557 Embassy Pkwy
Fairlawn, OH 44333
Phone (330) 670-1005

667 Eastland Ave SE
Warren, OH 44484
Phone (330) 841-2378

349 Niles Cortland Rd NE
Warren, OH 44484
Phone (330) 372-0260

667 Eastland Ave SE
Fl 5
Warren, OH 44484
Phone (330) 841-4750

1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182

8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929

Interoperability endpoints

  • Direct secure messaging: zdavis42868@direct.bsmhealth.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1360195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1952640146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 NILES CORTLAND RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841976",
            "telephone_number": "330-372-0260",
            "fax_number": "330-372-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 NILES CORTLAND RD NE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444841976",
            "telephone_number": "330-372-0260",
            "fax_number": "330-372-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ZACHARY",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "MSN, APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-02-07",
        "last_updated": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.14275NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.14275",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "RN363464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0081456",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.