LARISSA DAVIS NPI 1063832731

NPI Information

  • NPI: 1063832731
  • Provider Name: LARISSA DAVIS
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 200 DOCTORS DR
    STE 201
    DOUGLAS, GA
    ZIP 31533
  • Phone: (912) 384-9460

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NPI Details

Larissa Davis is a family nurse practitioner in Douglas, GA. Larissa Davis NPI is 1063832731. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

200 DOCTORS DR
STE 201
DOUGLAS, GA
ZIP 31533-201
Phone: (912) 384-9460
Fax: (912) 393-1239

The NPI 1063832731 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus (HCPCS:87426)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit (HCPCS:G0438)
  • Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza (HCPCS:87428)
  • Automated urinalysis test (HCPCS:81003)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)

The enumeration date for this NPI number is 4/22/2014 and was last updated on 9/6/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyRN197160GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1003145835AMEDICAIDGEORGIA
2RN197160OTHERGEORGIAMEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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