Active NPI
Mary Katherine Davis, MD
- Pediatrics Physician
- Huntersville, NC
National Provider Identifier
1083875355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2013-00671
- Practice address
- 9625 Northcross Center CT
Ste 201
Huntersville, NC 28078-7348 - Phone
- (704) 801-3097
- NPI assigned
- Jun 19, 2008
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2013-00671 | NC | Primary |
Addresses
Primary practice location
9625 Northcross Center CT
Ste 201
Huntersville, NC 28078-7348
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mdavis137085@CarolinasHealthcareSystem.direct-ci.com | Atrium Health | |
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130905000557 | NC | Practitioner - Pediatric Medicine | 5890951974 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Lake Pediatrics | Pediatrics | Current | Accepting new patients |
| Carolinas Physicians Network Inc | Pediatrics | Past | Accepting new patients |
Locations
100 N 6th St
Ste 900A
Minneapolis, MN 55403
9625 Northcross Center Ct
Ste 201
Huntersville, NC 28078
Phone (704) 801-3097
Interoperability endpoints
- mdavis137085@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Huntersville, NC
- NPI 1295766079
-
- Pediatrics Physician
- Charlotte, NC
- NPI 1619582343
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1083875355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19305",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282199305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9625 NORTHCROSS CENTER CT",
"address_2": "STE 201",
"city": "HUNTERSVILLE",
"state": "NC",
"postal_code": "280787348",
"telephone_number": "704-801-3097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MARY",
"middle_name": "KATHERINE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-19",
"last_updated": "2024-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2013-00671",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mdavis137085@CarolinasHealthcareSystem.direct-ci.com",
"affiliation": "Y",
"affiliationName": "Atrium Health",
"address_1": "9625 Northcross Center Ct",
"address_2": "Ste 201",
"city": "Huntersville",
"state": "NC",
"country_code": "US",
"postal_code": "280787348",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "ABILITY Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Huntersville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.