Larissa Davis, - Medicare Nurse Practitioner in Douglas, GA

  1. Home
  2. Nurse Practitioner
  3. GA
  4. Douglas
Larissa Davis, is a medicare enrolled "Nurse Practitioner - Family" in Douglas, Georgia. Her current practice location is 200 Doctors Dr, Ste 201, Douglas, Georgia. You can reach out to her office (for appointments etc.) via phone at (912) 384-9460.

Larissa Davis is licensed to practice in Georgia (license number RN197160) 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 1063832731.

Contact Information

Larissa Davis,
200 Doctors Dr, Ste 201,
Douglas, GA 31533-2201
(912) 384-9460
(912) 393-1239

Map and Direction




Provider's Profile

Full NameLarissa Davis
GenderFemale
SpecialityNurse Practitioner - Family
Location200 Doctors Dr, Douglas, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1063832731
  • Provider Enumeration Date: 04/22/2014
  • Last Update Date: 09/06/2017
  Medicare PECOS Information:
  • PECOS PAC ID: 8729202593
  • Enrollment ID: I20140617002336

Medical Identifiers

Medical identifiers for Larissa Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063832731NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family RN197160 (Georgia)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. Larissa Davis allows following entities to bill medicare on her behalf.
Entity NamePeachtree Immediate Care FP, LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437194156
PECOS PAC ID: 3274559323
Enrollment ID: O20051019000049
Entity NameCoffee Emergency Group LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023353489
PECOS PAC ID: 4880834050
Enrollment ID: O20130711000400

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. Larissa 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 AddressPractice Location Address
Larissa Davis,
1100 Ward St Ext W,
Douglas, GA 31534-1902

Ph: Not Available		Larissa Davis,
200 Doctors Dr, Ste 201,
Douglas, GA 31533-2201

Ph: (912) 384-9460

Reviews and Comments


Nurse Practitioner Nurses in Douglas, GA

Jennifer Kay Davis, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 901 Connector 206 N, Douglas, GA 31533
Phone: 912-389-6885    Fax: 912-393-1015
Taylor Lamar Gibson, NP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 200 Doctors Dr Ste O, Douglas, GA 31533
Phone: 912-383-5655    Fax: 912-389-2117
Mrs. Shanda Deleice Carter, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 205 Shirley Ave, Douglas, GA 31533
Phone: 912-383-6966    
Sarah Simmons Mikell, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 303 Shirley Ave Ste B, Douglas, GA 31533
Phone: 912-384-2474    
Mrs. Nancy Danielle Collins, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 903 Ward St W Ste B, Douglas, GA 31533
Phone: 912-384-4111    Fax: 912-384-4117
Kera Ashlyn Malphus,
Nurse Practitioner
Medicare: May Accept Medicare Assignments
Practice Location: 1001 Ward St W, Douglas, GA 31533
Phone: 912-384-7210    
Patricia Arasely Jaimes,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1101 Ocilla Rd, Douglas, GA 31533
Phone: 912-384-1900    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.