MEDICARE: STACY FAITH DAVIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	27614	TN
2	207RC0000X	Cardiovascular Disease Physician	27614	TN
3	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	27614	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P01376946	OTHER	TN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	6012044	OTHER	TN	BCBS

General Provider Information

NPI Number	:	1942203963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY FAITH DAVIS M.D.

Provider Business Mailing Address
First Line	:	3024 BUSINESS PARK CIR
Second Line	:
City	:	GOODLETTSVILLE
State	:	TN
Zip	:	37072-3132
Country	:	US
Telephone Number	:	615-239-2018
Fax Number	:	615-851-2018

Provider Business Practice Location Address
First Line	:	4230 HARDING PIKE STE 900
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37205-4900
Country	:	US
Telephone Number	:	615-964-5841
Fax Number	:	615-250-4100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	02/27/2025

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Directions to “ STACY FAITH DAVIS M.D.” Practice Location

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