MRS. MITRA MANSOURI DAVIS CNM
NPI 1164574844
Advanced Practice Midwife in Atlanta, GA

Q: What is the provider's specialty?

The provider's specialty is Advanced Practice Midwife with taxonomy code 367A00000X.

Active since January 16, 2007PECOS Enrolled

1100 JOHNSON FERRY RD, SUITE 800, ATLANTA, GA 30342(404) 252-1137(404) 252-6794 Get Directions Write a Review

NPPES record last updated: February 2, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Mrs. Mitra Mansouri Davis Cnm NPPES

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

MRS. MITRA MANSOURI DAVIS CNM (NPI 1164574844) is an individual advanced practice midwife in Atlanta, Georgia, licensed in Georgia (RN112909) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164574844

Entity TypeIndividualFemale

Primary Taxonomy367A00000X

Provider Legal NameMRS. MITRA MANSOURI DAVISCredential: CNM

Location Address1100 JOHNSON FERRY RD, SUITE 800Atlanta, GA 30342-1709

Mailing Address1100 Johnson Ferry Rd, Suite 800Atlanta, GA 30342-1709 · (404) 252-1137 · Fax (404) 252-6794

Phone(404) 252-1137

Fax(404) 252-6794

Sole ProprietorNo

Enumeration DateJanuary 16, 2007

Last NPPES UpdateFebruary 2, 2016

✔ NPI 1164574844 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367A00000X

License✔ Licensed in GA · RN112909

Definition

Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.

1100 JOHNSON FERRY RD, Atlanta, GA 30342

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mrs. Mitra Mansouri Davis Cnm has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 1, 2016 through March 1, 2026.

Opt-Out Effective DateMarch 1, 2016

Opt-Out In Effect ThroughMarch 1, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30342 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$70.85 typical visit price

range $18.22 – $140.40

Typical copayment $17.71 (range $4.55 – $35.10)

Most-billed visit code 99213

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