Active NPI
Kourtney Davis
- Family Nurse Practitioner
- Concord, NC
National Provider Identifier
1245174358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 5024460
- Practice address
- 920 Church St N
Concord, NC 28025-2927 - Phone
- (704) 403-3000
- NPI assigned
- Apr 17, 2026
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5024460 | NC | Primary |
| Registered Nurse | 163W00000X | 299106 | NC |
Addresses
Primary practice location
920 Church St N
Concord, NC 28025-2927
Mailing address
920 Church St N
Concord, NC 28025-2927
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
10 Little Brook Rd
West Wareham, MA 02576-1222
4055 Valley View LN
Suite 400
Dallas, TX 75244-5071
PO Box
Suite 1431
Charlotte, NC 28201
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 299106 | NC | MD | Registered Nurse |
| 5024460 | NC | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778630400000",
"number": "1245174358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 CHURCH ST N",
"city": "CONCORD",
"state": "NC",
"postal_code": "280252927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 CHURCH ST N",
"city": "CONCORD",
"state": "NC",
"postal_code": "280252927",
"telephone_number": "704-403-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KOURTNEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-04-17",
"last_updated": "2026-05-13",
"certification_date": "2026-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5024460",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "299106",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.