SOPHOAN DAVIS - NPI 1003647942 - Nurse Practitioner in Albuquerque, NM

Q: What is Sophoan Davis's NPI number?

The NPI number for Sophoan Davis is 1003647942. It was assigned to this individual provider in the NPPES registry on August 12, 2024.

Q: What is Sophoan Davis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Sophoan Davis was last updated on June 29, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Sophoan Davis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOPHOAN DAVIS (NPI 1003647942) is an individual family provider in Albuquerque, New Mexico, licensed in New Mexico (61154) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1003647942

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSOPHOAN DAVIS

Location Address4010 MONTGOMERY BLVD NEAlbuquerque, NM 87109-1186

Mailing Address4010 Montgomery Blvd NeAlbuquerque, NM 87109-1186 · (505) 254-6100

Phone(505) 254-6100

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateAugust 12, 2024

Last NPPES UpdateJune 29, 2026

NPPES CertifiedJune 29, 2026

✔ NPI 1003647942 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NM · 61154

4010 MONTGOMERY BLVD NE, Albuquerque, NM 87109

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sophoan Davis is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6709357445

PECOS Enrollment IDI20260603004623

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87109 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.79 typical visit price

range $54.26 – $166.80

Typical copayment $21.19 (range $13.56 – $41.70)

Most-billed visit code 99203

Established Patient

$96.38 typical visit price

range $17.00 – $135.35

Typical copayment $24.09 (range $4.25 – $33.83)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. NICOLE ANN BADILLO CNP

Nurse Practitioner (Women's Health)