LARISSA DAVIS (NPI# 1063832731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063832731 |
| Entity Type | Individual |
| Full Name | LARISSA DAVIS |
| Practice Address |
200 Doctors Dr Ste 201 Douglas GA 31533-2201 |
| Mailing Address |
1100 Ward St Ext W Douglas GA 31534-1902 |
| Practice Telephone | 9123849460 |
| Practice Fax Number | 9123931239 |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2017-09-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN197160 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICAL LICENSE | RN197160 | 01 |
| GA | 003145835A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154836575 | Larissa Christine Davis | Specialist/Technologist | 1 John Marshall Dr, Huntington, WV 25755-0002 | 2017-12-07 |
| 1326435140 | Larissa Davis | Case Manager/Care Coordinator | 218 Dogwood Hollow Rd, Mountain View, AR 72560-7942 | 2015-04-20 |
| 1760874705 | Larissa Davis | Counselor | 4851 Independence St, Suite 200, Wheat Ridge, CO 80033-6715 | 2015-02-27 |
| Street Address |
200 DOCTORS DR STE 201 |
| City | DOUGLAS |
| State | GA |
| Zip Code | 31533-2201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750374294 | Hemachandran P Nair | Internal Medicine | 200 Doctors Dr, Suite 106, Douglas, GA 31533-2201 | 2005-08-30 |
| 1760856405 | Crh Physician Practices LLC | General Practice | 200 Doctors Dr, Suite S, Douglas, GA 31533-2201 | 2015-11-18 |
| 1417388687 | Crh Physician Practices, LLC | Psychiatry & Neurology | 200 Doctors Dr, Suite L, Douglas, GA 31533-2201 | 2013-12-12 |
| 1417396342 | Joi Livingston Rogers | Pediatrics | 200 Doctors Dr, Suite 201, Douglas, GA 31533-2201 | 2013-06-25 |
| 1477997278 | Phoebe Family Medicine,coffee County | Clinic/Center | 200 Doctors Dr, Ste 224, Douglas, GA 31533-2201 | 2013-04-23 |
| 1255682142 | Crh Physician Practices LLC | Pediatrics | 200 Doctors Dr, Ste 201, Douglas, GA 31533-2201 | 2012-10-02 |
| 1417207796 | Crh Physician Practices LLC | Urology | 200 Doctors Dr, Ste 220, Douglas, GA 31533-2201 | 2012-09-14 |
| 1427305507 | Debra Sharon Luke | Nurse Practitioner | 200 Doctors Dr, Suite 106, Douglas, GA 31533-2201 | 2012-08-08 |
| 1669745345 | South Georgia Eye Partners PC | Optometrist | 200 Doctors Dr, Suite 290, Douglas, GA 31533-2201 | 2012-02-11 |
| 1467724740 | Costrini & Meadows, PC | Internal Medicine | 200 Doctors Dr, Suite 112, Douglas, GA 31533-2201 | 2012-02-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
| 1811528649 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 211 North Street, Douglas, GA 31533 | 2020-01-30 |
| 1952940793 | Teresa Smith | Pharmacist | 901 W Ward St, Douglas, GA 31533 | 2019-12-26 |
| 1447641048 | Jennifer Spivey | Nurse Practitioner | 326 Shirley Avenue, Douglas, GA 31533 | 2015-02-18 |
| 1972914497 | Jessica Lynne Courson | Nurse Practitioner | 903 West Ward Street, Suite B, Douglas, GA 31533 | 2014-05-19 |
| 1063840296 | South Central Primary Care Center | Clinic/Center | 303 Shirley Ave, Ste B, Douglas, GA 31533 | 2013-10-25 |
| 1336411008 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 118 Coweta Avenue South, Douglas, GA 31533 | 2012-01-27 |
| 1346482700 | V and V Clinic | Pediatrics | 1020 West Bryan Street, Douglas, GA 31533 | 2009-04-01 |
| 1063650406 | Jayla Snipes Bullock | Speech-Language Pathologist | 618 Bowens Mill Road Sw, Douglas, GA 31533 | 2009-01-22 |
| 1417112707 | Southern Community Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 315 S. Gaskin Ave, Douglas, GA 31533 | 2008-07-25 |
| Find all providers in zip 31533 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013551829 | Taylor Lamar Gibson | Nurse Practitioner | 200 Doctors Dr Ste O, Douglas, GA 31533-2202 | 2019-11-05 |
| 1952879918 | Monica Nichole Roberts | Nurse Practitioner | 210 Peterson Ave S, Douglas, GA 31533-5237 | 2018-11-08 |
| 1770058539 | Carlas Paulk | Nurse Practitioner | 28 Tempa Ln, Douglas, GA 31535-4561 | 2018-10-09 |
| 1053801860 | Brandon Hall | Nurse Practitioner | 903 Ward St W Ste A, Douglas, GA 31533-3536 | 2018-05-16 |
| 1235508920 | Michelle Martinez Jones | Nurse Practitioner | 200 Doctors Dr Ste S, Douglas, GA 31533-2203 | 2015-09-23 |
| 1447641048 | Jennifer Spivey | Nurse Practitioner | 326 Shirley Avenue, Douglas, GA 31533 | 2015-02-18 |
| 1457758609 | Angela Leah Overturf | Nurse Practitioner | 100 East 5th Street, Douglas, AZ 85607 | 2014-12-02 |
| 1063817872 | Amanda Brulte | Nurse Practitioner | 100 Doctors Dr Ste 104, Douglas, GA 31533-2211 | 2014-10-23 |
| 1720481500 | La. Donna Spikes | Nurse Practitioner | 208 Grady Ave S, Douglas, GA 31533-2312 | 2014-10-07 |
| 1972914497 | Jessica Lynne Courson | Nurse Practitioner | 903 West Ward Street, Suite B, Douglas, GA 31533 | 2014-05-19 |
| Find all providers in DOUGLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.