Active NPI
Kimberly D Davis, APN
- Nurse Practitioner
- Chicago, IL
National Provider Identifier
1083589592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 2019010808
- Practice address
- 5700 S Maryland Ave
Chicago, IL 60637-1426 - Phone
- (773) 702-1000
- NPI assigned
- Oct 6, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 2019010808 | IL | Primary |
Addresses
Primary practice location
5700 S Maryland Ave
Chicago, IL 60637-1426
Mailing address
5700 S Maryland Ave
Chicago, IL 60637-1426
Phone (773) 702-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4055 Valley View LN
Suite 700
Dallas, TX 75244-4910
4055 Valley View LN
Suite 700
Dallas, TX 75244-5045
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019010808 | IL | MD | Nurse Practitioner |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759708800000",
"number": "1083589592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5700 S MARYLAND AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371426",
"telephone_number": "773-702-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5700 S MARYLAND AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606371426",
"telephone_number": "773-702-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KIMBERLY",
"middle_name": "D",
"credential": "APN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-10-06",
"last_updated": "2025-10-06",
"certification_date": "2025-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "2019010808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.