Individual provider Active NPI

Kelsey Rose Davis

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1255953766
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW024531 Issued in PA
Practice address
1650 Market St Ste 3600
Philadelphia, PA 19103-7334
Phone
(323) 205-7088
NPI assigned
May 7, 2020
Last updated
Feb 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X CW024531 PA Primary

Addresses

Primary practice location

1650 Market St Ste 3600
Philadelphia, PA 19103-7334

Mailing address

1650 Market St Ste 3600
Philadelphia, PA 19103-7334

Other practice location 1

165 E Park Ave
Niles, OH 44446-2352
Phone (330) 544-8005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CW024531PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cadence Care Network CurrentSince Oct 4, 2020 Accepting new patients
Cadence Care Network CurrentSince Jul 31, 2021 Accepting new patients

Locations

165 E Park Ave
Niles, OH 44446
Phone (330) 544-8005

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1588809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1255953766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 MARKET ST STE 3600",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191037334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 MARKET ST STE 3600",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191037334",
            "telephone_number": "323-205-7088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "165 E Park Ave",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "OH",
            "postal_code": "444462352",
            "country_code": "US",
            "telephone_number": "330-544-8005",
            "fax_number": "330-544-9379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KELSEY",
        "middle_name": "ROSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-07",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW024531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.