Active NPI
Lisa M Davis, NNP-BC
- Nurse Practitioner
- Wilmington, DE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- L1-0033857
- Practice address
- 1600 Rockland Rd
Wilmington, DE 19803 - Phone
- (302) 651-4200
- Fax
- (302) 651-4945
- NPI assigned
- May 9, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Neonatal Nurse Practitioner | 363LN0005X | SP012019 | PA | |
| Nurse Practitioner | 363L00000X | L1-0033857 | DE | Primary |
Addresses
Primary practice location
1600 Rockland Rd
Wilmington, DE 19803
Mailing address
PO Box 191
Rockland, DE 19732-0191
Phone (302) 651-4200
Other practice location 1
34th Street and Civic Center Boulevard
Philadelphia, PA 19104-4399
Phone (215) 776-7123
Other practice location 2
34th Street and Civic Center Boulevard
Philadelphia, PA 19104-4399
Phone (215) 776-7123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD, DE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L1-0033857 | DE | MD | Nurse Practitioner |
| SP012019 | PA | MD | Critical Care Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Nemours Foundation | Current | Accepting new patients | |
| The Nemours Foundation | Current | Accepting new patients | |
| The Nemours Foundation | Past | Accepting new patients |
Locations
1600 Rockland Rd
Wilmington, DE 19803
701 N Clayton St
Ste 400
Wilmington, DE 19805
Phone (302) 421-9700
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.
-
- Multi-Specialty Clinic/Center
- Wilmington, DE
- NPI 1366594699
-
- Family Medicine Physician
- Baltimore, MD
- NPI 1598718256
-
- Children's Hospital
- Wilmington, DE
- NPI 1467505073
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1265585806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570579200000",
"number": "1952660144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 191",
"city": "ROCKLAND",
"state": "DE",
"postal_code": "197320191",
"telephone_number": "302-651-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 ROCKLAND RD",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "19803",
"telephone_number": "302-651-4200",
"fax_number": "302-651-4945"
}
],
"practiceLocations": [
{
"address_1": "34th Street and Civic Center Boulevard",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191044399",
"country_code": "US",
"telephone_number": "215-776-7123",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "34th Street and Civic Center Boulevard",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191044399",
"country_code": "US",
"telephone_number": "215-776-7123",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "LISA",
"middle_name": "M",
"credential": "NNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-09",
"last_updated": "2019-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0005X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal, Critical Care",
"state": "PA",
"license": "SP012019",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "DE",
"license": "L1-0033857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.