MRS. DALLAS JORDAN DAVIS PROVENCE NP
NPI 1619556230
Dermatology - Dermatopathology in Memphis, TN

Q: What is Dallas Provence's NPI number?

The NPI number for Dallas Provence is 1619556230. It was assigned to this individual provider in the NPPES registry on April 2, 2021. The provider is also known as Dallas Jordan Davis Np.

Q: What is Dallas Provence's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Dermatopathology, with taxonomy code 207ND0900X.

Q: When was this NPI record last updated?

The NPPES record for Dallas Provence was last updated on April 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 02, 2021PECOS EnrolledAccepts Medicare Assignment

6254 POPLAR AVE, MEMPHIS, TN 38119(901) 624-3333 Get Directions Write a Review

NPPES record last updated: April 2, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mrs. Dallas Jordan Davis Provence Np NPPES

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

MRS. DALLAS JORDAN DAVIS PROVENCE NP (NPI 1619556230) is an individual dermatopathology provider in Memphis, Tennessee, licensed in Tennessee (28973) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1619556230

Entity TypeIndividualFemale

Primary Taxonomy207ND0900X

Provider Legal NameMRS. DALLAS JORDAN DAVIS PROVENCECredential: NP

Location Address6254 POPLAR AVEMemphis, TN 38119-4713

Mailing Address295 Pandora StMemphis, TN 38117-2854 · (901) 338-1340

Phone(901) 624-3333

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateApril 2, 2021

NPPES CertifiedMarch 14, 2021

✔ NPI 1619556230 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · DermatopathologyAllopathic & Osteopathic Physicians

Taxonomy Code207ND0900X

License✔ Licensed in TN · 28973

Definition

A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes.

6254 POPLAR AVE, Memphis, TN 38119

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Other Names 1

Former Name (1)Dallas Jordan Davis Np

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, Oscar Health Plan, Inc., Oscar Insurance Company and more.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

Mrs. Dallas Jordan Davis Provence 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 ID4688079338

PECOS Enrollment IDI20210819000167

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 11

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.

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

681 services128 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

423 services327 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

236 services187 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

202 services184 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

136 services118 patients

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.

115 services108 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38119 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

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

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.

Other Providers at the Same Location NPPES 3

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

MAGDALENA SHAPAKER FNP-C

Nurse Practitioner (Family)

6254 POPLAR AVE
MEMPHIS, TN 38119

Shelby County (901) 336-2236

MRS. LAUREN PLYLER AG-ACNP-BC

Nurse Practitioner (Acute Care)

6254 POPLAR AVE
MEMPHIS, TN 38119

Shelby County (901) 624-3333

JESSICA POWELL ZARSHENAS NP

Nurse Practitioner (Family)

6254 POPLAR AVE
MEMPHIS, TN 38119

Shelby County (901) 624-3333

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dallas Provence's NPI number?

The NPI number for Dallas Provence is 1619556230. It was assigned to this individual provider in the NPPES registry on April 2, 2021. The provider is also known as Dallas Jordan Davis Np.

Where is Dallas Provence located?

Dallas Provence practices at 6254 Poplar Ave, Memphis, TN 38119. The listed phone number is (901) 624-3333.

What is Dallas Provence's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Dermatopathology, with taxonomy code 207ND0900X.

Is Dallas Provence enrolled in Medicare?

Yes. Dallas Provence is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Dallas Provence accept?

Health plans from BlueCross BlueShield of Tennessee, Oscar Health Plan, Inc., Oscar Insurance Company and UnitedHealthcare list Dallas Provence as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dallas Provence was last updated on April 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.