MR. MARK ANTHONY DAVIS PMHNP-BC
NPI 1265296412
Nurse Practitioner - Psychiatric/Mental Health in Walla Walla, WA

Q: What is Mark Davis's NPI number?

The NPI number for Mark Davis is 1265296412. It was assigned to this individual provider in the NPPES registry on February 8, 2024.

Q: What is Mark Davis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Mark Davis was last updated on February 8, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since February 08, 2024PECOS Enrolled

1520 KELLY PL, WALLA WALLA, WA 99362(509) 575-4084 Get Directions Write a Review

NPPES record last updated: February 8, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Mr. Mark Anthony Davis Pmhnp-bc NPPES

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

MR. MARK ANTHONY DAVIS PMHNP-BC (NPI 1265296412) is an individual psychiatric/mental health provider in Walla Walla, Washington, licensed in Washington (AP61526319) and active in the NPI registry since February 2024. He is enrolled in Medicare PECOS, is affiliated with Providence St Mary Medical Center, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1265296412

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameMR. MARK ANTHONY DAVISCredential: PMHNP-BC

Location Address1520 KELLY PLWalla Walla, WA 99362-8607

Mailing Address1520 Kelly PlWalla Walla, WA 99362-8607 · (509) 575-4084

Phone(509) 575-4084

Sole ProprietorYes

Medical School CMSOtherGraduated 2023

Enumeration DateFebruary 8, 2024

NPPES CertifiedJanuary 30, 2024

✔ NPI 1265296412 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in WA · AP61526319

1520 KELLY PL, Walla Walla, WA 99362

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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)

Mr. Mark Anthony Davis Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID941649354

PECOS Enrollment IDI20240529002577

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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

50 services23 patients

Hospital Affiliations CMS Care Compare

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

Providence St Mary Medical Center

Acute Care Hospitals · Walla Walla, WA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500002

Location401 W Poplar StWalla Walla, WA 99362 · Walla Walla County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99362 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

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$100.78 typical visit price

range $18.56 – $141.11

Typical copayment $25.19 (range $4.64 – $35.27)

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 20

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

DAYNIS GARCIA PURECO

Registered Nurse