Ked Davis MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

AR-E-5314 Issued in AR

Legal business name

KED DAVIS MD

Doing business as

Ked L Davis MD PLLC PA

Practice address

1701 E North St
Magnolia, AR 71753-3204

Phone

(870) 234-3802

Fax

(870) 234-7386

NPI assigned

Jul 11, 2008

Organization subpart

No

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

Authorized official

Name

Ashley Campbell

Title

Office Manager

Phone

(870) 234-3802

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• KED L DAVIS MD PLLC PA Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ked L Davis, M.D.

  • Family Medicine Physician
  • Magnolia, AR
  • NPI 1699981894

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1316101058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 E NORTH ST",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717533204",
            "telephone_number": "870-234-3802",
            "fax_number": "870-234-7386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 E NORTH ST",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717533204",
            "telephone_number": "870-234-3802",
            "fax_number": "870-234-7386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KED DAVIS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-11",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-234-3802"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "AR-E-5314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167832001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KED L DAVIS MD PLLC PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laken Kacie Jones, B.A.
• Valerie Suzanne Jones, PHARMD
• Joseph G. Bussell, DDS PA
• Summer Joslin
• Journey to Grow LLC
• Jan Kiilsgaard, LAT, ATC
• Mary Kimbell, MHPP
• Cathy Tate Kinnard, PLMSW
• Johnny Knighten
• Kourtney Langheld

• Family Medicine Physician in Magnolia, AR
• Providers in Magnolia, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.