Individual provider Active NPI

Valen Rivers Davis, FNP

  • Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1972790871
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP116329 Issued in TX
Practice address
906 W Cannon St Ste a
Fort Worth, TX 76104-3031
Phone
(817) 321-0404
NPI assigned
Sep 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP116329 TX Primary
Nurse Practitioner 363L00000X 706554 TX

Addresses

Primary practice location

906 W Cannon St Ste a
Fort Worth, TX 76104-3031

Mailing address

816 W Cannon St
Fort Worth, TX 76104-3146
Phone (817) 321-0404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20080109000327 TX Practitioner - Nurse Practitioner 2860572385 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP116329TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of North Texas PA CurrentSince Mar 4, 2019 Accepting new patients
Radiology Associates of North Texas PA CurrentSince Mar 4, 2019 Accepting new patients
Clinical Care in Radiology Past Accepting new patients

Locations

17980 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 248-1303

816 W Cannon St
Ft Worth, TX 76104
Phone (817) 321-0312

1429 Clear Lake Rd
Ste 400
Weatherford, TX 76086
Phone (817) 321-0312

Organizations & group practices 3

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": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1972790871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W CANNON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043146",
            "telephone_number": "817-321-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 W CANNON ST STE A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043031",
            "telephone_number": "817-321-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "VALEN",
        "middle_name": "RIVERS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP116329",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "706554",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.