Individual provider Active NPI

Jayme Lauren Davis-Waddell, NP-C

  • Family Nurse Practitioner
  • Bowling Green, KY
National Provider Identifier
1992120075
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3008548 Issued in KY
Practice address
990 Wilkinson Trce
Bowling Green, KY 42103-3404
Phone
(270) 781-4043
Fax
(270) 781-4196
NPI assigned
Feb 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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 3008548 KY Primary

Addresses

Primary practice location

990 Wilkinson Trce
Bowling Green, KY 42103-3404

Mailing address

201 Park St
Bowling Green, KY 42101-1708
Phone (270) 781-4043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20140611001685 KY Practitioner - Nurse Practitioner 8123242245 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
Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

990 Wilkinson Trce
Bowling Green, KY 42103-3404
Phone (270) 781-4043

Hospital & facility affiliations

  • Family Home Health Care, LLC Dba Adoration Home Health Home health agency, Columbia, KY, CCN 187119
  • The Medical Center (Bowling Green) Hospital, Bowling Green, KY, CCN 180013

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Gilbert Clinic PLLC CurrentSince Feb 8, 2021 Accepting new patients
Hospital Medicine Services of Ky, LLC Family CurrentSince Apr 1, 2023 Accepting new patients
Graves Gilbert Clinic PLLC CurrentSince Feb 8, 2021 Accepting new patients

Locations

1801 Ashley Cir
Bowling Green, KY 42104
Phone (270) 781-4330

990 Wilkinson Trce
Bowling Green, KY 42103
Phone (270) 781-4043

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

Interoperability endpoints

  • Direct secure messaging: jaymedavis-waddell@ggc.allscriptsdirect.net

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.

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": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1992120075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011708",
            "telephone_number": "270-781-4043",
            "fax_number": "270-781-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 WILKINSON TRCE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421033404",
            "telephone_number": "270-781-4043",
            "fax_number": "270-781-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-WADDELL",
        "first_name": "JAYME",
        "middle_name": "LAUREN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-25",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.