Kimberly Rose Davis MD Inc Apmc

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

A142106 Issued in CA

Legal business name

KIMBERLY ROSE DAVIS MD INC APMC

Practice address

2181 Citracado Parkwy
Escondido, CA 92029-4159

Phone

(442) 277-6100

NPI assigned

Sep 28, 2017

Organization subpart

No

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

Authorized official

Name

Kimberly R Davis, MDNPI 1265799878

Title

Owner/President

Phone

(858) 461-9866

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kimberly Rose Davis, MD INC A Professional Medical Corporation Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly R Davis, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Escondido, CA
  • NPI 1265799878
  Medicare reassignment NPD Authorized official
• Ryan Fraiser, DO

  • Physical Medicine & Rehabilitation Physician
  • La Jolla, CA
  • NPI 1871980789
  Medicare reassignment NPD

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630972800000",
    "number": "1316456734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 SOUTH SIERRA # 1167",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920752050",
            "telephone_number": "858-461-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2181 CITRACADO PARKWY",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920294159",
            "telephone_number": "442-277-6100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2185 Citracado Pkwy",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920294159",
            "country_code": "US",
            "telephone_number": "442-281-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "153 South Sierra # 1167",
            "address_purpose": "LOCATION",
            "city": "Solana Beach",
            "state": "CA",
            "postal_code": "920752050",
            "country_code": "US",
            "telephone_number": "858-461-9866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIMBERLY ROSE DAVIS MD INC APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-28",
        "last_updated": "2021-09-07",
        "certification_date": "2021-08-19",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "858-461-9866",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A142106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A142106",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kimberly Rose Davis, MD INC A Professional Medical Corporation",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Kimberly Rose Davis, MD INC A Professional Medical Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hyeryung Kim
• Kwangrae Andrew Kim, D.D.S
• Robert M Kim, DDS
• Uesin Kim
• Venice Kim
• Kelsie Alexandra Kinden, PSYD
• Brandon King
• Kerry King, PH.D.
• Lisa Jean Kinney-Ham, M.D.
• Liora Kirby, PA-C

• Medical Specialty Clinic/Center in Escondido, CA
• Providers in Escondido, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2021; 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.