SHIRLEY J DAVIS NP
NPI 1104390285
Nurse Practitioner - Family in Kingsport, TN

Q: What is Shirley Davis's NPI number?

The NPI number for Shirley Davis is 1104390285. It was assigned to this individual provider in the NPPES registry on January 11, 2019.

Q: What is Shirley 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 Shirley Davis was last updated on August 16, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 11, 2019PECOS EnrolledAccepts Medicare Assignment

2202 N JOHN B DENNIS HWY STE 100, KINGSPORT, TN 37660(423) 578-8500(423) 578-8569 Get Directions Write a Review

NPPES record last updated: August 16, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 16, 2024, Jan 11, 2019 (2 updates tracked since 2019).

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About Shirley J Davis Np NPPES

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

SHIRLEY J DAVIS NP (NPI 1104390285) is an individual family provider in Kingsport, Tennessee, licensed in Tennessee (25089) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS, is affiliated with Wellmont Holston Valley Medical Center, and maintains a secondary practice location in Gray.

NPPES Registry Identity

NPI1104390285

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSHIRLEY J DAVISCredential: NP

Location Address2202 N JOHN B DENNIS HWY STE 100Kingsport, TN 37660-5904

Mailing Address1021 W Oakland Ave Ste 310Johnson City, TN 37604-2192 · (423) 302-6565

Phone(423) 578-8500

Fax(423) 578-8569

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJanuary 11, 2019

Last NPPES UpdateAugust 16, 20242 updates tracked since enumeration

NPPES CertifiedAugust 16, 2024

✔ NPI 1104390285 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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

Taxonomy Code363LF0000X

License✔ Licensed in TN · 25089

Also ListedRegistered NurseTaxonomy 163W00000X · License 154824 (TN)

2202 N JOHN B DENNIS HWY STE 100, Kingsport, TN 37660

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Secondary Practice Location 1

Location 1115 Judge Gresham Rd Ste AGray, TN 37615-6213 · Phone (423) 467-3000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shirley J Davis Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456692185

PECOS Enrollment IDI20190408000807

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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wellmont Holston Valley Medical Center

Acute Care Hospitals · Kingsport, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440017

Location130 West Ravine RoadKingsport, TN 37662 · Sullivan County

Emergency services

Indian Path Community Hospital

Acute Care Hospitals · Kingsport, TN

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number440176

Location2000 Brookside DrKingsport, TN 37660 · Sullivan County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37660 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

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.

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Other Providers at the Same Location NPPES 13

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

DR. SWETHA PADURI MD

Internal Medicine (Hematology & Oncology)