JOHANNA DAVIS (FNP) – Family Nurse Practitioner, NPI 1154677334

JOHANNA DAVIS (FNP) is a healthcare provider. based in Rangeley, Maine. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. R058417 (ME). The NPI Number for JOHANNA DAVIS (FNP) is 1154677334

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
JOHANNA DAVIS (FNP)
NPI
1154677334
Phone
(207) 864-2699
Address
42 DALLAS HILL RD
Enumeration Date
25 July 2012
Last Update Date
25 July 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2076609924
Graduation Year
2012 (14 years ago)
PAC ID
1658529367
Group Practice PAC ID
5496726523
Professional Enrollment ID
I20120920000601
Address ID
ME049174370BE4XXXXWAYX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

1,869 NURSE PRACTITIONER in ME

Provider Addresses for JOHANNA DAVIS (FNP)

  • 42 DALLAS HILL RD

    RANGELEY, ME 049700569

    Phone: (207) 864-2699

    Fax: (207) 864-2969

    Type: Mailing

  • 8 SOUTH MAIN ST

    MADISON, ME 04950

    Phone: (207) 696-3992

    Fax: (207) 696-3974

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-09-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120920000601INurse PractitionerMETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
83036Hemoglobin a1c level3419$0
View full utilization report →

Insurance plans in this area (ZIP 04970)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5496726523View full group profile
NameSpecialtyState
Clinical Social WorkerME
Family PracticeID
Clinical Social WorkerME
Nurse PractitionerWA
Nurse PractitionerNH
-ME
Nurse PractitionerME
Clinical Social WorkerME
Family PracticeME
-ME

Reviews

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Frequently asked questions

How do I look up JOHANNA DAVIS (FNP) by NPI?
Use NPI 1154677334 when you need to reference JOHANNA DAVIS (FNP) in forms, claims, or directories.
Is JOHANNA DAVIS (FNP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is JOHANNA DAVIS (FNP)?
The page reflects Family Nurse Practitioner for JOHANNA DAVIS (FNP). Clinical services aligned with this taxonomy classification.
Where is JOHANNA DAVIS (FNP)'s primary listing?
We display Rangeley, Maine because that is what the record indicates for JOHANNA DAVIS (FNP).
What if Rangeley, Maine seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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