Individual provider Active NPI

Alexandria Ashley Davis, FNP-C

  • Family Nurse Practitioner
  • Ashdown, AR
National Provider Identifier
1962980797
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A005656 Issued in AR
Practice address
820 S Locust St
Ashdown, AR 71822-4347
Phone
(870) 898-4576
Fax
(870) 455-4484
NPI assigned
Aug 2, 2018
Last updated
Aug 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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 A005656 AR Primary

Addresses

Primary practice location

820 S Locust St
Ashdown, AR 71822-4347

Mailing address

820 S Locust St
Ashdown, AR 71822-4347
Phone (870) 898-4576

Other identifiers 1

IdentifierTypeStateIssuer
230845758MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20180928001508 AR Practitioner - Nurse Practitioner 9032460191 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

820 S Locust St
Ashdown, AR 71822-4347
Phone (870) 898-4576

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Grace Healthcare Inc. Family CurrentSince Oct 14, 2021 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jan 20, 2026 Accepting new patients

Locations

820 S Locust St
Ashdown, AR 71822
Phone (870) 898-4576

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: alexandriadavis@fmgt.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Southern Grace Healthcare IncAshdown, AR, CCN 043951 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer
Corporate Director
W-2 Managing Employee
Jun 1, 2024
Jun 1, 2024
Jun 1, 2024
Jun 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1962980797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S LOCUST ST",
            "city": "ASHDOWN",
            "state": "AR",
            "postal_code": "718224347",
            "telephone_number": "870-898-4576",
            "fax_number": "870-455-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S LOCUST ST",
            "city": "ASHDOWN",
            "state": "AR",
            "postal_code": "718224347",
            "telephone_number": "870-898-4576",
            "fax_number": "870-455-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ALEXANDRIA",
        "middle_name": "ASHLEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-02",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A005656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230845758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashdown, AR

Sources for this page

Verify at the official NPI Registry.