Individual provider Active NPI

Kimberly Wolfe Davis, DNP,APRN, FNP-BC

  • Nurse Practitioner
  • Troy, MI
National Provider Identifier
1295433282
Registry record updated Dec 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704346834 Issued in MI
Practice address
2075 W Big Beaver Rd
Troy, MI 48084-3407
Phone
(248) 817-2685
Fax
(248) 817-5202
NPI assigned
Feb 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704346834 MI Primary
Registered Nurse 163W00000X 1135976 KY

Addresses

Primary practice location

2075 W Big Beaver Rd
Troy, MI 48084-3407

Mailing address

1803 S Delano St
Saint Clair, MI 48079-5553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240528003634 MI Practitioner - Nurse Practitioner 3173965753 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1135976KYMDRegistered Nurse
4704346834MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Medical Group Nurse Practitioner CurrentSince Jan 1, 2025 Accepting new patients
Ih Physician Services PC CurrentSince Apr 21, 2025 Accepting new patients
Ih Physician Services, PC CurrentSince Apr 21, 2025 Accepting new patients
McLaren Medical Group CurrentSince Jan 1, 2025 Accepting new patients

Locations

39425 Garfield Rd
Ste 22A
Clinton Township, MI 48038
Phone (586) 649-3181

39373 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 286-4880

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

695 Kenmoor Ave SE
Ste B1
Grand Rapids, MI 49546
Phone (616) 438-9902

1163 S Carney Dr
Saint Clair, MI 48079
Phone (810) 561-8450

26211 Central Park Blvd
Ste 600
Southfield, MI 48076
Phone (248) 936-2075

655 Brawley School Rd
Ste 200
Mooresville, NC 28117

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1295433282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 S DELANO ST",
            "city": "SAINT CLAIR",
            "state": "MI",
            "postal_code": "480795553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 W BIG BEAVER RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843407",
            "telephone_number": "248-817-2685",
            "fax_number": "248-817-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFE DAVIS",
        "first_name": "KIMBERLY",
        "credential": "DNP,APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704346834",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1135976",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.