Individual provider Active NPI

Kathleen Susan Davis, MSN, AGPCNP-C

  • Nurse Practitioner
  • Houston, TX
National Provider Identifier
1346832904
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1100338 Issued in TX
Practice address
6560 Fannin St Ste 2200
Houston, TX 77030-2715
Phone
(678) 852-2642
NPI assigned
Feb 5, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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 1100338 TX Primary
Registered Nurse 163W00000X 0000222645 TN

Addresses

Primary practice location

6560 Fannin St Ste 2200
Houston, TX 77030-2715

Mailing address

6560 Fannin St Ste 2200
Houston, TX 77030-2715
Phone (678) 852-2642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20240301000729 TX Practitioner - Nurse Practitioner 9032554910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMH Physicians and Surgeons, PLLCGroup PAC ID 1557586070, 29 clinicians

Practice addresses (Care Compare)

6560 Fannin St
Suite 2200
Houston, TX 77030-2715
Phone (713) 441-6106

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0000222645TNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
TMH Physicians and Surgeons, PLLC CurrentSince Feb 26, 2024 Accepting new patients
TMH Physician Organization Past Accepting new patients
Methodist Radiology Associates, PLLC Past Accepting new patients
Premium Choice Physicians Nurse Practitioner PastSince Nov 1, 2023 Accepting new patients

Locations

6560 Fannin St
Ste 2200
Houston, TX 77030
Phone (713) 441-6106

Interoperability endpoints

  • Direct secure messaging: kdavis430140@directhoustonmethodist.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1346832904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST STE 2200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302715",
            "telephone_number": "678-852-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6560 FANNIN ST STE 2200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302715",
            "telephone_number": "678-852-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KATHLEEN",
        "middle_name": "SUSAN",
        "credential": "MSN, AGPCNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1100338",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "0000222645",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.