Individual provider Active NPI

Kyle Andrew Davis, MD

  • Pediatric Hematology & Oncology Physician
  • Indianapolis, IN
National Provider Identifier
1124446984
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Hematology & Oncology PhysicianTaxonomy code 2080P0207X
License
01083879A Issued in IN
Practice address
8326 Naab Rd
Indianapolis, IN 46260-1920
Phone
(317) 871-0000
Fax
(317) 871-0010
NPI assigned
Mar 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1124446984 OH
Pediatrics Physician 208000000X 01083879A IN
Pediatric Hematology & Oncology Physician 2080P0207X 01083879A IN Primary

Addresses

Primary practice location

8326 Naab Rd
Indianapolis, IN 46260-1920

Mailing address

8326 Naab Rd
Indianapolis, IN 46260-1920
Phone (317) 871-0000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address teamnursing@ihtc.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200710001312 IN Practitioner - Pediatric Medicine 0749581437 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1124446984OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Hematology, Inc CurrentSince Mar 12, 2024 Accepting new patients
Indiana Hemophilia & Thrombosis Center, Inc. CurrentSince Aug 1, 2020 Accepting new patients
Major Hospital Past Accepting new patients

Locations

3900 Washington Ave
#100
Evansville, IN 47714
Phone (317) 871-0000

8326 Naab Rd
Indianapolis, IN 46260
Phone (317) 338-7200

Interoperability endpoints

  • Direct secure messaging: kyle.davis.1@25782.direct.athenahealth.com

Organizations & group practices 3

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": "1396137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1124446984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8326 NAAB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601920",
            "telephone_number": "317-871-0000",
            "fax_number": "317-871-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8326 NAAB RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601920",
            "telephone_number": "317-871-0000",
            "fax_number": "317-871-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KYLE",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-30",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "1124446984",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01083879A",
            "primary": false
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "IN",
            "license": "01083879A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "teamnursing@ihtc.org",
            "affiliation": "N",
            "address_1": "8326 Naab Rd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462601920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.