Individual provider Active NPI

Kathy Dai Davis, C.R.N.P.

  • Family Nurse Practitioner
  • Linthicum Heights, MD
National Provider Identifier
1104975622
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R144682 Issued in MD
Practice address
785 Elkridge Landing Rd Ste 300
Linthicum Heights, MD 21090-2958
Phone
(443) 323-3014
Fax
(855) 212-5249
NPI assigned
Jan 10, 2007
Last updated
Jun 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R144682 MD Primary

Addresses

Primary practice location

785 Elkridge Landing Rd Ste 300
Linthicum Heights, MD 21090-2958

Mailing address

813 Maiden Choice LN
Baltimore, MD 21228-3679
Phone (410) 402-2258

Other practice location 1

711 Maiden Choice Ln
Catonsville, MD 21228-3632
Phone (410) 247-5602

Other identifiers 6

IdentifierTypeStateIssuer
P00726215OtherGARAILROAD MEDICARE
152584ZDVXOtherMDMEDICARE
E402 0022OtherDCCAREFIRST
1221809OtherAMERIGROUP
416893300OtherMDMEDICAL ASSISTANCE
94951602OtherMDCAREFIRST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090609000295 MD Practitioner - Nurse Practitioner 4082764337 Reassigns benefits to 5 organizations
I20100320000038 DC Practitioner - Nurse Practitioner 4082764337 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthdrive Medical Services PCGroup PAC ID 1355863952, 33 clinicians

Practice addresses (Care Compare)

12325 New Hampshire Ave
Silver Spring, MD 20904-2957
Phone (888) 964-6681

6700 Alexander Bell Dr
Suite 200
Columbia, MD 21046-2105
Phone (888) 964-6681

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.12 of 100Reported as group
Quality
78.81
Promoting interoperability
100
Improvement activities
40
Cost
65.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthdrive Medical Services Southeast LLC Family CurrentSince Aug 1, 2025 Accepting new patients
Healthdrive Medical Services, PC Family CurrentSince May 1, 2025 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1300 I St NW
Ste 400E
Washington, DC 20005
Phone (202) 902-7324

6700 Alexander Bell Dr
Ste 200
Columbia, MD 21046
Phone (201) 581-3411

12325 New Hampshire Ave
Silver Spring, MD 20904
Phone (301) 622-4600

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1104975622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 MAIDEN CHOICE LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212283679",
            "telephone_number": "410-402-2258",
            "fax_number": "410-204-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 ELKRIDGE LANDING RD STE 300",
            "city": "LINTHICUM HEIGHTS",
            "state": "MD",
            "postal_code": "210902958",
            "telephone_number": "443-323-3014",
            "fax_number": "855-212-5249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "711 Maiden Choice Ln",
            "address_purpose": "LOCATION",
            "city": "Catonsville",
            "state": "MD",
            "postal_code": "212283632",
            "country_code": "US",
            "telephone_number": "410-247-5602",
            "fax_number": "410-242-1756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KATHY",
        "middle_name": "DAI",
        "name_prefix": "Ms.",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R144682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00726215",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "152584ZDVX",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "E402  0022",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "1221809",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "416893300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "94951602",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Linthicum Heights, MD

Sources for this page

Verify at the official NPI Registry.