Keith E Davis, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M4888 Issued in ID

Practice address

113 S Apple St
Shoshone, ID 83352-5287

Phone

(208) 886-2224

Fax

(208) 886-2634

NPI assigned

Apr 27, 2006

Last updated

Nov 15, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: keith.davis.d1.p1@direct.fhsid.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Burley, ID
  • NPI 1033165550

  Family Medicine

  Medicare reassignment NPD
• Keith E Davis

  dba Shoshone Family Medical Center

  • Rural Health Clinic/Center
  • Shoshone, ID
  • NPI 1972673218
  Authorized official Same address or phone
• Lincoln Community Health

  • Community/Behavioral Health Agency
  • Shoshone, ID
  • NPI 1689814980
  Authorized official Same address or phone
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Rupert, ID
  • NPI 1093761694

  Family Medicine

  NPD
• Family Health Services Corporation

  dba Family Health Services

  • Federally Qualified Health Center (FQHC)
  • Twin Falls, ID
  • NPI 1235279217

  Family Medicine

  NPD
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Fairfield, ID
  • NPI 1316984529

  Family Medicine

  NPD
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Kimberly, ID
  • NPI 1659946861
  NPD
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Shoshone, ID
  • NPI 1841932498

  Family Medicine

  NPD
• Southern Idaho Diabetes Education Program

  • Primary Care Clinic/Center
  • Shoshone, ID
  • NPI 1154572311
  NPD
• Andrew L McCall DPM PA

  dba Ankle and Foot Clinic of Idaho

  • Podiatrist
  • Idaho Falls, ID
  • NPI 1134342256
  NPD (past)
• Family Health Services Corporation

  dba Family Health Services

  • Federally Qualified Health Center (FQHC)
  • Buhl, ID
  • NPI 1003862525

  Family Medicine

  NPD (past)
• Family Health Services Corporation

  • Federally Qualified Health Center (FQHC)
  • Jerome, ID
  • NPI 1073188728

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289779200000",
    "number": "1043277635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 S. APPLE ST.",
            "address_2": "PO BOX 609",
            "city": "SHOSHONE",
            "state": "ID",
            "postal_code": "833520609",
            "telephone_number": "208-886-2224",
            "fax_number": "208-886-2634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 S APPLE ST",
            "city": "SHOSHONE",
            "state": "ID",
            "postal_code": "833525287",
            "telephone_number": "208-886-2224",
            "fax_number": "208-886-2634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KEITH",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2010-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M4888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahs of Idaho (SUWS Adolescent & Youth Programs)
• Melissa Brown, RN
• Cascades at Lincoln County, LLC (Lincoln County Care Center)
• Charolais Care IV, Inc (Lincoln County Care Center)
• Martha Mary Clements, PT
• Katelyn Rose Denison, RN
• Family Health Services Corporation
• Family Health Services Corporation
• Gooding Pharmacy Inc (Shoshone Pharmacy)
• Barbara Hapayan, NP

• Family Medicine Physician in Shoshone, ID
• Providers in Shoshone, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.