THEODORA LACY DAVIS
NPI 1730054271
Nurse Practitioner in Erie, PA

Q: 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.

Q: What is Theodora Davis's specialty?

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

Q: 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 10 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.

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: August 02, 2026.

On this page

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, and ordering and referring status from the CMS PECOS system.

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.

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.

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 10 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.