Active NPI
Kelly Kimble Davis, MD
- Student in an Organized Health Care Education/Training Program
- Gainesville, FL
National Provider Identifier
1184328809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1600 SW Archer Rd
Gainesville, FL 32610-3003 - Phone
- (352) 273-8234
- NPI assigned
- Mar 28, 2023
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1600 SW Archer Rd
Gainesville, FL 32610-3003
Mailing address
604 E Raintree LN
Goldsboro, NC 27534-8225
Phone (919) 222-3277
Other practice location 1
417 Macnider Hall
Cb# 7221
Chapel Hill, NC 27599-7221
Phone (919) 966-7495
Other names 1
- Kelly Ann Kimble
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 |
|---|---|---|---|---|
| I20260520004513 | NC | Order and Referring Only - Pediatric Medicine | 5395214126 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773360000000",
"number": "1184328809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 E RAINTREE LN",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275348225",
"telephone_number": "919-222-3277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 SW ARCHER RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326103003",
"telephone_number": "352-273-8234"
}
],
"practiceLocations": [
{
"address_1": "417 Macnider Hall",
"address_2": "Cb# 7221",
"address_purpose": "LOCATION",
"city": "Chapel Hill",
"state": "NC",
"postal_code": "275997221",
"country_code": "US",
"telephone_number": "919-966-7495",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "KELLY",
"middle_name": "KIMBLE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-28",
"last_updated": "2026-03-13",
"certification_date": "2026-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "KIMBLE",
"middle_name": "ANN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; 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.