Active NPI
Kelly Lynn Davis
- Case Manager/Care Coordinator
- Long Beach, CA
National Provider Identifier
1043527385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 456 Elm Ave
Long Beach, CA 90802-2426 - Phone
- (562) 437-6717
- Fax
- (562) 447-5592
- NPI assigned
- Sep 8, 2010
- Last updated
- Sep 8, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
456 Elm Ave
Long Beach, CA 90802-2426
Mailing address
10247 San Carlos Ave
South Gate, CA 90280-6534
Phone (323) 395-7494
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283904000000",
"number": "1043527385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10247 SAN CARLOS AVE",
"city": "SOUTH GATE",
"state": "CA",
"postal_code": "902806534",
"telephone_number": "323-395-7494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "456 ELM AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908022426",
"telephone_number": "562-437-6717",
"fax_number": "562-447-5592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KELLY",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-08",
"last_updated": "2010-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.