Nicole Davis, MS, RDN, LDN is a medicare enrolled "Dietitian, Registered" provider in Ozark, Illinois. She graduated from medical school in 2013 and has 13 years of diverse experience with area of expertise as Registered Dietitian Or Nutrition Professional. She is a member of the group practice Shawnee Health Service And Development Corp and her current practice location is
350 Zach Ln, Ozark, Illinois. You can reach out to her office (for appointments etc.) via phone at
(618) 889-9570.
Nicole Davis is licensed to practice in Illinois (license number 164.006153) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1871975938.
Healthcare Provider's Profile
| Full Name | Nicole Davis |
|---|
| Gender | Female |
|---|
| Speciality | Registered Dietitian Or Nutrition Professional |
|---|
| Experience | 13 Years |
|---|
| Location | 350 Zach Ln, Ozark, Illinois |
|---|
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Nicole Davis graduated from medical school in 2013
NPI Data:
- NPI Number: 1871975938
- Provider Enumeration Date: 06/25/2015
- Last Update Date: 02/04/2026
Medicare PECOS Information:
- PECOS PAC ID: 4688980808
- Enrollment ID: I20150903000256
Medical Identifiers
Medical identifiers for Nicole Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1871975938 | NPI | - | NPPES |
| 1065198 | Other | | COMMISSION ON DIETETIC REGISTRATION |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | 164.006153 (Illinois) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Shawnee Health Service And Development Corp | 1658285671 | 50 |
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. Nicole Davis allows following entities to bill medicare on her behalf.
| Provider Name | Shawnee Health Service And Development Corp |
|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
|---|
| Provider Identifiers | NPI Number: 1639295314
PECOS PAC ID: 1658285671
Enrollment ID: O20031120000454 |
|---|
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. Nicole 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 |
|---|
Nicole Davis, MS, RDN, LDN
350 Zach Ln,
Ozark, IL 62972-1119
Ph: (618) 889-9570 | Nicole Davis, MS, RDN, LDN
350 Zach Ln,
Ozark, IL 62972-1119
Ph: (618) 889-9570 |
Reviews and Comments