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THEODORA LACY DAVIS
NPI 1730054271
Nurse Practitioner in Erie, PA

Active since October 06, 2025PECOS Enrolled
120 E 2ND ST STE 400, ERIE, PA 16507(814) 456-8980 Get Directions Write a Review

NPPES record last updated: October 6, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Theodora Lacy Davis NPPES

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

THEODORA LACY DAVIS (NPI 1730054271) is an individual nurse practitioner in Erie, Pennsylvania, licensed in Pennsylvania (SP034083) and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1730054271
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameTHEODORA LACY DAVIS
Location Address120 E 2ND ST STE 400Erie, PA 16507-1577
Mailing Address808 Michigan BlvdErie, PA 16505-3810 · (814) 456-8980
Phone(814) 456-8980
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateOctober 6, 2025
NPPES CertifiedOctober 6, 2025
✔ NPI 1730054271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in PA · SP034083
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
120 E 2ND ST STE 400, Erie, PA 16507
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Other Names 1

Other Name (5)Lacy Davis

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID2961994280
PECOS Enrollment IDI20251124004353
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.

Medicare Billing Reassignment

Medicare enrollment records show Theodora Davis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Regional Health Services Inc
0.1 mi
Family Medicine
201 STATE ST
Erie, PA 16550
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 962 clinicians in this Medicare group
NPI 1174520654 (814) 877-8140

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16507 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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 3

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

EMINA VAKUFAC PA
Physician Assistant (Medical)
120 E 2ND ST STE 400
ERIE, PA 16507
Erie County (814) 877-5600
ANDREA MANCUSO HOLMGREN PA-C
Physician Assistant (Surgical)
120 E 2ND ST STE 400
ERIE, PA 16507
Erie County (814) 877-5600
LESLEE ANN LEWIS PA-C
Physician Assistant
120 E 2ND ST STE 400
ERIE, PA 16507
Erie County (814) 456-8980

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 Theodora Davis's NPI number?

The NPI number for Theodora Davis is 1730054271. It was assigned to this individual provider in the NPPES registry on October 6, 2025. The provider is also known as Lacy Davis.

Where is Theodora Davis located?

Theodora Davis practices at 120 E 2nd St Ste 400, Erie, PA 16507. The listed phone number is (814) 456-8980.

What is Theodora Davis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Theodora Davis enrolled in Medicare?

Yes. Theodora Davis is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Theodora Davis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theodora Davis reassigns Medicare benefits to Regional Health Services Inc (Erie, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Theodora Davis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Theodora Davis was last updated on October 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.