Kelly Ranae Davis, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209023957 Issued in IL

Practice address

2500 W Higgins Rd Ste 1040
Hoffman Estates, IL 60169-2049

Phone

(847) 884-8096

Fax

(847) 884-8125

NPI assigned

Aug 25, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, IL2 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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Specialists of Illinois, LTDGroup PAC ID 7517288236, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.8 of 100Reported as group

Promoting interoperability

88

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgreer@directaddress.net

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.

• Dermatology Specialists of Illinois, LTD

  • Dermatology Physician
  • Algonquin, IL
  • NPI 1144610080

  IL

  Medicare reassignment Care Compare group NPD
• Soderstrom Dermatology Center S C

  • Dermatology Physician
  • Peoria, IL
  • NPI 1710931670

  IA

  Medicare reassignment
• Algonquin Family Chiropractic LTD.

  • Chiropractor
  • Algonquin, IL
  • NPI 1336696889
  NPD

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1265109409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W HIGGINS RD STE 1040",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601692049",
            "telephone_number": "847-884-8096",
            "fax_number": "847-884-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W HIGGINS RD STE 1040",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601692049",
            "telephone_number": "847-884-8096",
            "fax_number": "847-884-8125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2323 Naper Vl Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605635606",
            "country_code": "US",
            "telephone_number": "630-462-8680",
            "fax_number": "630-462-8685",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "738 W Northwest Hwy",
            "address_purpose": "LOCATION",
            "city": "Barrington",
            "state": "IL",
            "postal_code": "600102640",
            "country_code": "US",
            "telephone_number": "224-427-6789",
            "fax_number": "847-382-8993",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2500 S Highland Ave Ste 320",
            "address_purpose": "LOCATION",
            "city": "Lombard",
            "state": "IL",
            "postal_code": "601485390",
            "country_code": "US",
            "telephone_number": "331-946-7572",
            "fax_number": "630-480-4507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KELLY",
        "middle_name": "RANAE",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-25",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023957",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A165295",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela L Dantzler
• Haley Berlett Daris
• Andrea Das, M.D.
• Henry Gordon Davis III, MD
• Katherine Davis, LPC
• Pamela M Davis, LSCW
• Sarah Elizabeth Arden Davis, LCSW
• Mary E Davitt, APN, NP
• Jennifer Day, CADC
• Angela De Luca, OD

• All providers in Hoffman Estates, IL
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.

Verify at the official NPI Registry.