LISA MONDO DAVIS (NPI# 1770128613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770128613 |
| Entity Type | Individual |
| Full Name | LISA MONDO DAVIS |
| Credential | NP-C |
| Practice Address |
2728 Sunset Blvd Ste 300 West Columbia SC 29169-4815 |
| Mailing Address |
Po Box 6069 West Columbia SC 29171-6069 |
| Practice Telephone | 8037444940 |
| Practice Fax Number | 8037444938 |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2020-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
23416 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 90 Summit Centre Dr, Columbia, SC 292296926 | 8037444940 | 8037444938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306444633 | Lisa Davis | Technician | 595 Trenum Dr, Keyser, WV 26726-7058 | 2020-10-09 |
| 1366054454 | Lisa M Davis | Home Health Aide | 1300 H St Ne Apt 306, Washington, DC 20002-6827 | 2020-08-19 |
| 1689291452 | Lisa Davis | Dietitian, Registered | 5155 Crystal Brook Dr, Morristown, TN 37814-1598 | 2020-06-28 |
| 1760025407 | Lisa Davis | Speech-Language Pathologist | 7121 Wren Ave Nw, North Canton, OH 44720-7054 | 2019-10-25 |
| 1326699869 | Lisa M Davis | Registered Nurse | 295 Sumpter St, Brooklyn, NY 11233-2712 | 2019-09-26 |
| 1194223727 | Lisa Duncan Davis | Dietitian, Registered | 217 Harr Town Rd, Blountville, TN 37617-3830 | 2018-01-29 |
| 1114464708 | Lisa Davis | Nurse Practitioner | 16812 Eldamere Ave, Cleveland, OH 44128-1516 | 2017-01-20 |
| 1639613573 | Lisa Davis | Day Training, Developmentally Disabled Services | 8937 1/2 S Western Ave, Los Angeles, CA 90047-3549 | 2016-12-12 |
| 1275087264 | Lisa Davis | Dental Hygienist | 5901 Stone Pine Rd, Wilmington, DE 19808-1015 | 2016-08-08 |
| 1376919753 | Lisa Davis | Licensed Practical Nurse | 30780 Barrington St, Madison Heights, MI 48071-1834 | 2015-08-19 |
| Street Address |
2728 SUNSET BLVD STE 300 |
| City | WEST COLUMBIA |
| State | SC |
| Zip Code | 29169-4815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881667897 | Mitchell Wells Jacocks | Internal Medicine | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2006-02-09 |
| 1083211312 | Lexington Health Inc | Internal Medicine | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2020-10-09 |
| 1770116477 | Jamie L Odom | Nurse Practitioner | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2020-02-20 |
| 1033742531 | Keelin Jamaal Golden-maldonado | Nurse Practitioner | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2020-02-13 |
| 1912544198 | Casey Hendrix Purcell | Nurse Practitioner | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2019-12-05 |
| 1588200661 | Kaitlyn A Keenan | Nurse Practitioner | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2019-11-22 |
| 1265077622 | Rachel S Fogarty | Nurse Practitioner | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2019-11-08 |
| 1275093155 | Nyesha Nicole Hall | Nurse Practitioner | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2019-03-25 |
| 1700345303 | Kristina Allane Bristow | Nurse Practitioner | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2019-03-14 |
| 1609347129 | Jessica Jems Oing | Nurse Practitioner | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2018-12-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457960726 | Jerry Scott Oreilly | Physical Therapy Assistant | 100 Dreher Rd, Suite 100, West Columbia, SC 29169 | 2020-07-23 |
| 1134759921 | A&m Medical, LLC | Durable Medical Equipment & Medical Supplies | 1053 Sunset Boulevard, West Columbia, SC 29169 | 2020-01-21 |
| 1750946067 | First Physical Therapy, LLC | Clinic/Center | 100 Dreher Rd., Suite 100, West Columbia, SC 29169 | 2019-05-02 |
| 1295217545 | Tynaka Kwans Wilson | Nurse Practitioner | Sc House Calls Inc, 1053 Center Street, West Columbia, SC 29169 | 2018-09-04 |
| 1588183826 | Kimberly Jane Jennings | Registered Nurse | 1052 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2017-09-19 |
| 1164943213 | Jacob Luke Wayland | Emergency Medicine | Lexington Medical Center-emergency Medicine Dept, 2720 Sunset Blvd, West Columbia, SC 29169 | 2017-06-29 |
| 1740721232 | Heather Detwiler | Physical Therapy Assistant | 2705 Leaphart Rd., Carolina Gardens, West Columbia, SC 29169 | 2017-03-16 |
| 1588110761 | Virginia I Hall | Nurse Practitioner | 2720 Susnet Blvd, West Columbia, SC 29169 | 2016-08-29 |
| 1215395744 | Stacey Khalifa | Social Worker | 160 Medical Cir Fl 1, West Columbia, SC 29169 | 2016-01-28 |
| 1407252331 | Sandy Frye Boone | Counselor | 2318 Sunset Blvd # 2a, West Columbia, SC 29169 | 2014-11-04 |
| Find all providers in zip 29169 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932601903 | Jamie Andrews Odom | Nurse Practitioner | 2720 Sunset Blvd Ste 300, West Columbia, SC 29169-4810 | 2018-03-06 |
| 1336524115 | Mary C Ward | Nurse Practitioner | 3316 Plattsprings Rd, West Columbia, SC 29170 | 2015-07-22 |
| 1205072808 | Gerlanda Derr | Nurse Practitioner | 1053 Center St, West Columbia, SC 29169-6749 | 2009-01-02 |
| 1891306205 | Sarah Peden | Nurse Practitioner | 222 E Medical Ln Ste 400, West Columbia, SC 29169-4848 | 2020-08-11 |
| 1356969778 | Tiffany Ann Christian | Nurse Practitioner | 1053 Center Street, Sc House Calls Inc, West Columbia, SC 29169 | 2020-07-13 |
| 1770116477 | Jamie L Odom | Nurse Practitioner | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2020-02-20 |
| 1033742531 | Keelin Jamaal Golden-maldonado | Nurse Practitioner | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2020-02-13 |
| 1912544198 | Casey Hendrix Purcell | Nurse Practitioner | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2019-12-05 |
| 1588200661 | Kaitlyn A Keenan | Nurse Practitioner | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2019-11-22 |
| 1265077622 | Rachel S Fogarty | Nurse Practitioner | 2728 Sunset Blvd Ste 300, West Columbia, SC 29169-4815 | 2019-11-08 |
| Find all providers in WEST COLUMBIA | ||||
| City | WEST COLUMBIA |
| Zip Code | 29169 |
Please comment or provide details below to improve the information on LISA MONDO DAVIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.