Individual provider Active NPI

Tashamba Lashira Davis-Denson, FNP-C

  • Family Nurse Practitioner
  • Quitman, GA
National Provider Identifier
1972366730
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN292639 Issued in GA
Practice address
1901 W Screven St
Quitman, GA 31643-3913
Phone
(731) 394-1145
NPI assigned
Feb 5, 2024
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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 RN292639 GA Primary

Addresses

Primary practice location

1901 W Screven St
Quitman, GA 31643-3913

Mailing address

151 Ramblin Rd
Quitman, GA 31643-5804
Phone (229) 375-2364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240219000074 GA Practitioner - Nurse Practitioner 5294179297 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Health Providers II LLCGroup PAC ID 5395284616, 39 clinicians
Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians

Practice addresses (Care Compare)

1901 W Screven St
Quitman, GA 31643-3913
Phone (731) 394-1145

2040 Colonial Dr
Savannah, GA 31406-2226
Phone (731) 394-1145

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN292639GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Health Providers II LLC CurrentSince Jul 12, 2024 Accepting new patients
Ultra Health LLC CurrentSince Feb 7, 2024 Accepting new patients

Locations

1901 W Screven St
Quitman, GA 31643
Phone (229) 263-6100

2040 Colonial Dr
Savannah, GA 31406
Phone (912) 354-2752

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

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": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1972366730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 RAMBLIN RD",
            "city": "QUITMAN",
            "state": "GA",
            "postal_code": "316435804",
            "telephone_number": "229-375-2364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W SCREVEN ST",
            "city": "QUITMAN",
            "state": "GA",
            "postal_code": "316433913",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-DENSON",
        "first_name": "TASHAMBA",
        "middle_name": "LASHIRA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN292639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quitman, GA

Sources for this page

Verify at the official NPI Registry.