NICOLE DAVIS (NPI# 1538510151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538510151 |
| Entity Type | Individual |
| Full Name | NICOLE DAVIS |
| Practice Address |
4012 Carter St Vidalia LA 71373 |
| Mailing Address |
4012 Carter St Vidalia LA 71373-3013 |
| Practice Telephone | 6015976058 |
| Mailing Telephone | 6015976058 |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2018-06-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 171M00000X | Case Manager/Care Coordinator | 1358510151 | LA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932747524 | Nicole C Davis | Licensed Vocational Nurse | 2316 Tierra Chica Way, El Paso, TX 79938-4429 | 2019-12-15 |
| 1396210605 | Nicole Joy Davis | Registered Nurse | 2970 Pawnee Ct, Redding, CA 96001-3482 | 2018-10-12 |
| 1972086957 | Nicole Lynne Davis | Social Worker | 4507 N Ravenswood Ave Ste 111, Chicago, IL 60640-5218 | 2018-09-14 |
| 1881103935 | Nicole Davis | Physical Therapy Assistant | 1949 W Ray Rd Ste 23, Chandler, AZ 85224-4008 | 2017-09-21 |
| 1215471545 | Nicole Davis | Specialist/Technologist | 404 Juniper Dr, West Mifflin, PA 15122-1236 | 2016-12-05 |
| 1679932321 | Nicole Davis | Nurse Practitioner | 5206 W Village Pkwy Ste 10, Rogers, AR 72758-8137 | 2016-02-22 |
| 1851777619 | Nicole Davis | Nurse Practitioner | 1301 E 47th St # 2, Chicago, IL 60653-4507 | 2015-08-04 |
| 1386915627 | Nicole Elaine Davis | Pharmacist | 4371 Narrow Lane Rd Ste 100, Montgomery, AL 36116-2975 | 2012-01-18 |
| 1154656023 | Nicole Patrich Davis | Counselor | 1862 Princeton Ave # 206, College Park, GA 30337-3519 | 2009-10-12 |
| 1518107648 | Nicole Jeanette Davis | Occupational Therapist | 11310 Horton Rd, Goodrich, MI 48438-9497 | 2009-03-02 |
| Street Address |
4012 CARTER ST |
| City | VIDALIA |
| State | LA |
| Zip Code | 71373 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366852626 | Andrea Hart Browning | Counselor | 4012 Carter St, Vidalia, LA 71373-3013 | 2014-05-07 |
| 1114537826 | Lasheka Coleman Eanochs | Case Manager/Care Coordinator | 4012 Carter St, Vidalia, LA 71373-3013 | 2020-08-06 |
| 1952948531 | Latrice Brengettsy | Case Manager/Care Coordinator | 4012 Carter St, Vidalia, LA 71373-3013 | 2019-12-03 |
| 1003476490 | Lauren Cater | Case Manager/Care Coordinator | 4012 Carter St, Vidalia, LA 71373 | 2019-06-18 |
| 1558929562 | Adrian Johnson | Case Manager/Care Coordinator | 4012 Carter St, Vidalia, LA 71373-3013 | 2019-06-04 |
| 1568029031 | Shakeria Stumps | Case Manager/Care Coordinator | 4012 Carter St, Vidalia, LA 71373 | 2019-05-21 |
| 1750946000 | Stormy Hall | Case Manager/Care Coordinator | 4012 Carter St, Vidalia, LA 71373-3013 | 2019-05-02 |
| 1366900912 | Latanya Hawkins | Case Manager/Care Coordinator | 4012 Carter St, Vidalia, LA 71373-3013 | 2019-03-03 |
| 1346705209 | Valencia Shardai King | Case Manager/Care Coordinator | 4012 Carter St, Vidalia, LA 71373-3013 | 2019-02-05 |
| 1871061382 | Arthur Kennard Lewis Jr. | Counselor | 4012 Carter St, Vidalia, LA 71373-3013 | 2018-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513494 | Total Urgent Care | Clinic/Center | 4014 Carter Street, Vidalia, LA 71373 | 2020-03-13 |
| 1609412097 | Hulin Urgent Care Services, LLC | Clinic/Center | 4319 Highway 84, Vidalia, LA 71373 | 2019-11-21 |
| 1720562556 | Neashion Marie Davis | Counselor | 1644 B Carter Street. Suite #2, Vidalia, LA 71373 | 2018-09-18 |
| 1992292403 | Angelica Francheska Woods | Counselor | 1644 B. Carter Street Suite 2, Vidalia, LA 71373 | 2018-04-19 |
| 1164973780 | Linda Sherbia | Counselor | 1644 B Carter St., Suite 2, Vidalia, LA 71373 | 2016-10-19 |
| 1518418045 | Cheryl Clark | Case Manager/Care Coordinator | 1644 B Carter Suite 2, Vidalia, LA 71373 | 2016-10-19 |
| 1972054500 | Sherry Cade | Counselor | 1644 B Carter Street, Suite 2, Vidalia, LA 71373 | 2016-10-19 |
| 1457801136 | Sarai Johnson | Counselor | 1644 B Carter Street Suite 2, Vidalia, LA 71373 | 2016-10-06 |
| 1053766410 | Erin Fournet Woodruff | Physical Therapist | 402 Holly Street, Vidalia, LA 71373 | 2016-05-04 |
| 1184084113 | Troy Nolan Thomas Jr. | Counselor | 4012 Carter St., Vidalia, LA 71373 | 2016-03-03 |
| Find all providers in zip 71373 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518418045 | Cheryl Clark | Case Manager/Care Coordinator | 1644 B Carter Suite 2, Vidalia, LA 71373 | 2016-10-19 |
| 1184081853 | Breanna Walker | Case Manager/Care Coordinator | 1644 B Carter Street, Vidalia, LA 71373 | 2016-01-26 |
| 1487025953 | Felicia Bowman | Case Manager/Care Coordinator | 4012 Carter Street, Vidalia, LA 71373 | 2015-10-09 |
| 1326653536 | Colton Davis | Case Manager/Care Coordinator | 1109 Carter St Ste 10, Vidalia, LA 71373-3227 | 2020-09-14 |
| 1437764651 | Shelby Holsted | Case Manager/Care Coordinator | 1109 Carter St Ste 10, Vidalia, LA 71373-3227 | 2020-09-14 |
| 1114537826 | Lasheka Coleman Eanochs | Case Manager/Care Coordinator | 4012 Carter St, Vidalia, LA 71373-3013 | 2020-08-06 |
| 1730798547 | Valesha Johnson | Case Manager/Care Coordinator | 1109 Carter St Ste 10, Vidalia, LA 71373-3227 | 2020-07-28 |
| 1528677804 | Kenya Simmons | Case Manager/Care Coordinator | 1109 Carter St Ste 10, Vidalia, LA 71373-3227 | 2020-07-23 |
| 1477176733 | Danielle Spencer | Case Manager/Care Coordinator | 806 Carter St, Vidalia, LA 71373-3206 | 2020-05-21 |
| 1841826070 | April Frost | Case Manager/Care Coordinator | 1109 Carter St Ste 10, Vidalia, LA 71373-3227 | 2020-03-19 |
| Find all providers in VIDALIA | ||||
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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.