Lisa Davis, is a medicare enrolled "Dietitian, Registered" provider in Morristown, Tennessee. Her current practice location is
2307 W Andrew Johnson Hwy Ste 110, Morristown, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(423) 254-0547.
Lisa Davis is licensed to practice in Tennessee (license number 1199) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1689291452.
Healthcare Provider's Profile
| Full Name | Lisa Davis |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 2307 W Andrew Johnson Hwy Ste 110, Morristown, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1689291452
- Provider Enumeration Date: 06/28/2020
- Last Update Date: 12/16/2022
Medicare PECOS Information:
- PECOS PAC ID: 8325009269
- Enrollment ID: I20220216001446
Medical Identifiers
Medical identifiers for Lisa Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1689291452 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | 1199 (Tennessee) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Lisa Davis allows following entities to bill medicare on her behalf.
| Provider Name | East Tn Nutrition And Wellness |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1386379071
PECOS PAC ID: 6709262280
Enrollment ID: O20221006002281 |
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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. Lisa Davis 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 |
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Lisa Davis,
5155 Crystal Brook Dr,
Morristown, TN 37814-1598
Ph: (847) 361-3400 | Lisa Davis,
2307 W Andrew Johnson Hwy Ste 110,
Morristown, TN 37814-3298
Ph: (423) 254-0547 |
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