DR. ANGELO C. III DAVIS (DNP, PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1356107569

DR. ANGELO C. III DAVIS (DNP, PMHNP-BC) is a healthcare provider. based in Lincoln, Nebraska. specializing in NURSE PRACTITIONER. They hold the professional credentials DNP, PMHNP-BC. They hold a License No. 115041 (NE). The NPI Number for DR. ANGELO C. III DAVIS (DNP, PMHNP-BC) is 1356107569

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
DR. ANGELO C. III DAVIS (DNP, PMHNP-BC)
NPI
1356107569
Phone
(206) 999-6260
Address
6105 S 34TH ST APT 307
Enumeration Date
26 February 2024
Last Update Date
5 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4024766060211
Graduation Year
2022 (4 years ago)
PAC ID
2668810102
Group Practice PAC ID
0941199681
Professional Enrollment ID
I20240403002812
Address ID
NE685269523LI8550XCIRX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

2,114 NURSE PRACTITIONER in NE

Provider Addresses for DR. ANGELO C. III DAVIS (DNP, PMHNP-BC)

  • 6105 S 34TH ST APT 307

    LINCOLN, NE 685164796

    Phone: (206) 999-6260

    Type: Mailing

  • 8550 CUTHILLS CIR

    LINCOLN, NE 685269474

    Phone: (402) 476-6060

    Fax: (402) 476-6809

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 11 Open Payments records for all available years, with a total value of $250.

Total Amount is formed as General ($250) + Research ($0) + Ownership ($0) = $250.

Last reported payment date: 2024-12-12 • Largest payer in this snapshot: ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) ($99).

Total Amount

$250

General + Research + Ownership

Payments

11

Total payment records

General Amount

$250

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-12

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2024-04-03

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
I20240403002812INurse PractitionerNETBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 68516)

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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: 0941199681View full group profile
NameSpecialtyState
Nurse PractitionerNE
Mental Health CounselorNE
P S Y C H I A T R YNE
-NE
Mental Health CounselorNE
Nurse PractitionerNE
Nurse PractitionerNE
N E U R O L O G YNE
-NE
Mental Health CounselorNE

Reviews

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Frequently asked questions

Is DR. ANGELO C. III DAVIS (DNP, PMHNP-BC) listed with a National Provider Identifier?
Yes — DR. ANGELO C. III DAVIS (DNP, PMHNP-BC) has NPI 1356107569 on file in the registry.
Is there an active status for DR. ANGELO C. III DAVIS (DNP, PMHNP-BC)?
For scheduling context, DR. ANGELO C. III DAVIS (DNP, PMHNP-BC) is shown as active in the registry.
What expertise is attributed to DR. ANGELO C. III DAVIS (DNP, PMHNP-BC)?
DR. ANGELO C. III DAVIS (DNP, PMHNP-BC)'s specialty line reads Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Nebraska is DR. ANGELO C. III DAVIS (DNP, PMHNP-BC) registered?
Use Lincoln, Nebraska as the headline location for DR. ANGELO C. III DAVIS (DNP, PMHNP-BC) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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