Davera Corporation is a medicare enrolled "Nurse Practitioner - Family" provider in Grants Pass, Oregon. Their current practice location is
214 Ne Outlook Ave, Grants Pass, Oregon. You can reach out to their office (for appointments etc.) via phone at
(541) 471-1909.
Davera Corporation is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Davera Corporation
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1760946321.
Healthcare Provider's Profile
| Full Name | Davera Corporation |
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| Type | Facility |
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| Speciality | Nurse Practitioner - Family |
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| Location | 214 Ne Outlook Ave, Grants Pass, Oregon |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1760946321
- Provider Enumeration Date: 01/29/2019
- Last Update Date: 03/11/2020
Medicare PECOS Information:
- PECOS PAC ID: 5890035075
- Enrollment ID: O20190326001687
Medical Identifiers
Medical identifiers for Davera Corporation such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1760946321 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 225700000X | Massage Therapist | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Davera Corporation acts as a billing entity for following providers:
| Provider Name | David Ray |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1811135759
PECOS PAC ID: 0749346732
Enrollment ID: I20150324000929 |
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| Provider Name | Michelle Antoinette Kitchen |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1114771698
PECOS PAC ID: 4284178690
Enrollment ID: I20240626003143 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Davera Corporation is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Davera Corporation
214 Ne Outlook Ave,
Grants Pass, OR 97526-1412
Ph: (541) 471-1909 | Davera Corporation
214 Ne Outlook Ave,
Grants Pass, OR 97526-1412
Ph: (541) 471-1909 |
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