Kenneth James Davis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25MA04177300 Issued in NJ

Practice address

701 Newark Ave
Suite 212
Elizabeth, NJ 07208-3550

Phone

(908) 354-9500

Fax

(908) 354-9077

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Advocare, LLC

  • Pediatrics Physician
  • Marlton, NJ
  • NPI 1770538696
  Medicare reassignment NPD
• Advocare , LLC

  • Internal Medicine Physician
  • Manahawkin, NJ
  • NPI 1912762162
  NPD

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285650226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 NEWARK AVE",
            "address_2": "SUITE 212",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083550",
            "telephone_number": "908-354-9500",
            "fax_number": "908-354-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 NEWARK AVE",
            "address_2": "SUITE 212",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083550",
            "telephone_number": "908-354-9500",
            "fax_number": "908-354-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KENNETH",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA04177300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dornell Darby
• Dash and Company LLC
• Maria R. Davanzo, ATR-BC, LPC
• Caryne David, APN
• Rosario Davidson, PA-C
• Daybreak Adult Daycare at Elizabeth LLC
• DDD Behavioral Management
• Martha E De Crisce, DNP, APN, FNP-C
• Jessica Isabelle De Lamota, DO
• Aquiles Enmanuel De Leon Javier, MD

• Pediatrics Physician in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Pediatrics Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.