Ms Renette Davis, FNP - Medicare Nurse Practitioner in Kingsport, TN

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Ms Renette Davis, FNP is a medicare enrolled "Nurse Practitioner - Family" in Kingsport, Tennessee. Her current practice location is 130 W Ravine Rd, Kingsport, Tennessee. You can reach out to her office (for appointments etc.) via phone at (423) 224-4000.

Ms Renette Davis is licensed to practice in Tennessee (license number 6609) 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 1962423368.

Contact Information

Ms Renette Davis, FNP
130 W Ravine Rd,
Kingsport, TN 37660-3810
(423) 224-4000
Not Available

Map and Direction




Provider's Profile

Full NameMs Renette Davis
GenderFemale
SpecialityNurse Practitioner - Family
Location130 W Ravine Rd, Kingsport, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1962423368
  • Provider Enumeration Date: 07/21/2006
  • Last Update Date: 04/10/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 5799739777
  • Enrollment ID: I20171130001576

Medical Identifiers

Medical identifiers for Ms Renette Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1962423368NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family RN089429 (Tennessee)Secondary
363LF0000XNurse Practitioner - Family 6609 (Tennessee)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. Ms Renette Davis allows following entities to bill medicare on her behalf.
Entity NamePai Participant 1 Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093371312
PECOS PAC ID: 8123351954
Enrollment ID: O20211208001934
Entity NameM Medical Group, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780056168
PECOS PAC ID: 7719278597
Enrollment ID: O20221109000050
Entity NameCtl Of Va Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700503992
PECOS PAC ID: 6002289220
Enrollment ID: O20230308001993

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. Ms Renette 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
Ms Renette Davis, FNP
999 Executive Park Blvd, Suite 201,
Kingsport, TN 37660-4632

Ph: (423) 224-3250		Ms Renette Davis, FNP
130 W Ravine Rd,
Kingsport, TN 37660-3810

Ph: (423) 224-4000

Reviews and Comments


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Sherry Lynn Goode, NP
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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.