David Wayne Davis, is a medicare enrolled "Nurse Practitioner - Family" in Fort White, Florida. His current practice location is
238 Sw Cullen Ave, Fort White, Florida. You can reach out to his office (for appointments etc.) via phone at
(386) 497-1397.
David Wayne Davis is licensed to practice in Florida (license number 9384698) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1134609704.
Provider's Profile
| Full Name | David Wayne Davis |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Family |
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| Location | 238 Sw Cullen Ave, Fort White, Florida |
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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: 1134609704
- Provider Enumeration Date: 08/14/2018
- Last Update Date: 01/23/2023
Medicare PECOS Information:
- PECOS PAC ID: 1658615893
- Enrollment ID: I20181129000921
Medical Identifiers
Medical identifiers for David Wayne Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1134609704 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 9384698 (Florida) | 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. David Wayne Davis allows following entities to bill medicare on his behalf.
| Entity Name | Trenton Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1801826268
PECOS PAC ID: 2365359387
Enrollment ID: O20050428000865 |
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| Entity Name | Columbia Family Medicine |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104533173
PECOS PAC ID: 0042689366
Enrollment ID: O20221208001801 |
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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. David Wayne 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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David Wayne Davis,
238 Sw Cullen Ave,
Fort White, FL 32038-3536
Ph: (386) 497-1397 | David Wayne Davis,
238 Sw Cullen Ave,
Fort White, FL 32038-3536
Ph: (386) 497-1397 |
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