Dr Nicole Elaine Davis, MD, PHARMD is a medicare enrolled "Family Medicine" provider in Lakeland, Florida. Her current practice location is
3030 Harden Blvd, Lakeland, Florida. You can reach out to her office (for appointments etc.) via phone at
(863) 687-1100.
Dr Nicole Elaine Davis is licensed to practice in Florida (license number ME162422) 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 1386915627.
Healthcare Provider's Profile
| Full Name | Dr Nicole Elaine Davis |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 3030 Harden Blvd, Lakeland, 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: 1386915627
- Provider Enumeration Date: 01/18/2012
- Last Update Date: 04/10/2024
Medicare PECOS Information:
- PECOS PAC ID: 5395107197
- Enrollment ID: I20230810002530
Medical Identifiers
Medical identifiers for Dr Nicole Elaine Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1386915627 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 183500000X | Pharmacist | 14302 (Alabama) | Secondary |
| 207Q00000X | Family Medicine | ME162422 (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. Dr Nicole Elaine Davis allows following entities to bill medicare on her behalf.
| Entity Name | Lakeland Regional Health Systems Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1497748743
PECOS PAC ID: 8325952914
Enrollment ID: O20031118000384 |
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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. Dr Nicole Elaine 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 |
|---|
Dr Nicole Elaine Davis, MD, PHARMD
1109 E Fairview Ave Apt 300,
Montgomery, AL 36106-2239
Ph: (205) 617-1177 | Dr Nicole Elaine Davis, MD, PHARMD
3030 Harden Blvd,
Lakeland, FL 33803-7952
Ph: (863) 687-1100 |
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