NPIMap

Individual provider Active NPI

Kelsey M Davis-Humes, D.O

  • Family Medicine Physician
  • Memphis, MO
National Provider Identifier
1457701419
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
201734707 Issued in MO
Practice address
450 E Sigler Ave
Ste a
Memphis, MO 63555-1726
Phone
(660) 465-2828
Fax
(660) 465-2956
NPI assigned
Jun 20, 2016
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125.069458 IL
Family Medicine Physician 207Q00000X 201734707 MO Primary

Addresses

Primary practice location

450 E Sigler Ave
Ste a
Memphis, MO 63555-1726

Mailing address

450 E Sigler Ave
Ste a
Memphis, MO 63555-1726
Phone (660) 465-8513

Other names 1

  • Kelsey M Davis Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171114000071 MO Practitioner - Family Practice 7113219031 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scotland County Memorial HospitalGroup PAC ID 8224940366, shared by 6 NPIs, 32 clinicians

Practice addresses (Care Compare)

450 E Sigler Ave
Suite a
Memphis, MO 63555-1726
Phone (660) 465-2828

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
125.069458ILMDFamily Medicine Physician
201734707MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scotland County Memorial Hospital Current Accepting new patients
Scotland County Memorial Hospital Family Medicine Current Accepting new patients
Scotland County Memorial Hospital Family Medicine CurrentSince Nov 1, 2017 Accepting new patients
Scotland County Memorial Hospital Family Medicine CurrentSince Nov 1, 2017 Accepting new patients
Scotland County Memorial Hospital Family Medicine PastSince Jun 23, 2025 Accepting new patients

Locations

450 E Sigler Ave
Memphis, MO 63555
Phone (660) 465-2828

450 E Sigler Ave
Ste A
Memphis, MO 63555
Phone (660) 465-2828

11024 Jefferson St
Wyaconda, MO 63474
Phone (660) 479-5553

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1457701419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E SIGLER AVE",
            "address_2": "STE A",
            "city": "MEMPHIS",
            "state": "MO",
            "postal_code": "635551726",
            "telephone_number": "660-465-8513",
            "fax_number": "660-465-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 E SIGLER AVE",
            "address_2": "STE A",
            "city": "MEMPHIS",
            "state": "MO",
            "postal_code": "635551726",
            "telephone_number": "660-465-2828",
            "fax_number": "660-465-2956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS-HUMES",
        "first_name": "KELSEY",
        "middle_name": "M",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125.069458",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "201734707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "DAVIS",
            "middle_name": "M",
            "credential": "D.O",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Memphis, MO

Sources for this page

Verify at the official NPI Registry.