Nicole Davis, FNP-C, ENP-C is a medicare enrolled "Nurse Practitioner - Family" in Heber, Utah. She graduated from nursing school in 2024 and has 2 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Revere Health Pc and her current practice location is
1300 S Us-189, Heber, Utah. You can reach out to her office (for appointments etc.) via phone at
(435) 657-8000.
Nicole Davis is licensed to practice in Utah (license number 7921527-4405) 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 1558175562.
Provider's Profile
| Full Name | Nicole Davis |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 2 Years |
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| Location | 1300 S Us-189, Heber, Utah |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Nicole Davis graduated from nursing school in 2024
NPI Data:
- NPI Number: 1558175562
- Provider Enumeration Date: 02/03/2025
- Last Update Date: 07/13/2026
Medicare PECOS Information:
- PECOS PAC ID: 5193236149
- Enrollment ID: I20250617000504
Medical Identifiers
Medical identifiers for Nicole Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1558175562 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 7921527-4405 (Utah) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Revere Health Pc | 7517868508 | 407 |
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.
| Entity Name | Revere Health PC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093764805
PECOS PAC ID: 7517868508
Enrollment ID: O20040113000805 |
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| Entity Name | Stat MD LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1225411473
PECOS PAC ID: 7719295716
Enrollment ID: O20150924000832 |
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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. 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 |
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Nicole Davis, FNP-C, ENP-C
1300 S Us-189,
Heber City, UT 84032
Ph: (435) 657-8000 | Nicole Davis, FNP-C, ENP-C
1300 S Us-189,
Heber, UT 84032
Ph: (435) 657-8000 |
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