NPIMap

Individual provider Active NPI

Nancy D Davidson, NURSE PRACTITIONER

  • Nurse Practitioner
  • Princeton, WV
National Provider Identifier
1982691382
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
33507 Issued in WV
Practice address
200 12TH Street Ext
Princeton, WV 24740-2329
Phone
(304) 425-9541
NPI assigned
Sep 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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 33507 WV Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2021101359 WV

Addresses

Primary practice location

200 12TH Street Ext
Princeton, WV 24740-2329

Mailing address

200 12TH Street Ext
Princeton, WV 24740-2329
Phone (304) 425-9541

Other identifiers 2

IdentifierTypeStateIssuer
1104800671MedicaidVA
7104188000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040929001273 WV Practitioner - Nurse Practitioner 8628059250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern Highlands Community Mental Health Center IncGroup PAC ID 4486629235, 13 clinicians

Practice addresses (Care Compare)

19805 Coal Heritage Rd
Welch, WV 24801-2954
Phone (304) 436-2106

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021101359WVMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Highlands Community Mental Health Center, Inc. CurrentSince Feb 15, 2014 Accepting new patients
Greenbrier Valley Urology Associates, Inc Past Accepting new patients
Bluefield Pulmonary Consultants, Inc. PastSince May 1, 2003 Accepting new patients
Long Term Care of America-Virginia, Inc. Past Accepting new patients

Locations

200 12th Street Ext
Princeton, WV 24740
Phone (304) 425-9541

19805 Coal Heritage Rd
Welch, WV 24801
Phone (304) 425-9541

Interoperability endpoints

  • Direct secure messaging: nancy.davidson@bcmc.eclinicaldirectplus.com
  • FHIR API: https://api.platform.athenahealth.com/2276/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 12

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1982691382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402329",
            "telephone_number": "304-425-9541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 12TH STREET EXT",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402329",
            "telephone_number": "304-425-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "NANCY",
        "middle_name": "D",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-30",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "33507",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WV",
            "license": "2021101359",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104800671",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7104188000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

Verify at the official NPI Registry.