Kathleen Rose Davidson, RNCS

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

117767 PC Issued in MA

Practice address

20 Hope Ave
Suite G05
Waltham, MA 02453-2721

Phone

(781) 893-8762

Fax

(781) 899-6386

NPI assigned

Aug 31, 2006

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

Practice roles

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.

• Boston Psychiatry Group, Inc.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Waltham, MA
  • NPI 1205934924
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366554149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "351 MANNING ST",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024923442",
            "telephone_number": "781-444-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HOPE AVE",
            "address_2": "SUITE G05",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024532721",
            "telephone_number": "781-893-8762",
            "fax_number": "781-899-6386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "KATHLEEN",
        "middle_name": "ROSE",
        "credential": "RNCS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "117767  PC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Darnell, PHD
• Kelley Daron, LICSW
• Rebecca Darrah
• Elizabeth Davenport, LICSW
• Leon David, MA
• Samuel Davidson
• Aviva Davis
• Careyanne Dinisco Davis, PA-C
• Michelle Emery Davis, OTR/L
• Josette Camion Dawkins, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Waltham, MA
• Providers in Waltham, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.