KDD Vital Health and Consulting, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

KDD VITAL HEALTH AND CONSULTING, LLC

Practice address

16266 Prince Dr
South Holland, IL 60473-3233

Phone

(708) 222-7333

Fax

(708) 221-0501

NPI assigned

Dec 14, 2020

Organization subpart

No

Name

Kenisha DavisNPI 1033604954

Title

FNP

Phone

(708) 655-1482

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenisha Davis, APRN

  • Family Nurse Practitioner
  • South Holland, IL
  • NPI 1033604954

  Family

  NPD Authorized official

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 6, 2023.

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1104412246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1393 BRANDYWINE RD",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463079307",
            "telephone_number": "708-655-1482",
            "fax_number": "708-221-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16266 PRINCE DR",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604733233",
            "telephone_number": "708-222-7333",
            "fax_number": "708-221-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KDD VITAL HEALTH AND CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-14",
        "last_updated": "2023-09-06",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KENISHA",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "708-655-1482"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shimyra Jones
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• Paula Karll
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• Kemtos Incorporation
• Patricia Kenerson, COTA
• Kevlar Express Transit LLC
• Mohayya Khilfeh, M.D.
• Rajiv Khurana, D.D.S.

• All providers in South Holland, IL
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.