Individual provider Active NPI

Kim T Davis, CNM

  • Midwife
  • Los Angeles, CA
National Provider Identifier
1487670329
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
Practice address
8540 S Sepulveda Blvd Ste 1002
Los Angeles, CA 90045-3808
Phone
(310) 670-2085
Fax
(310) 670-8258
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X Primary

Addresses

Primary practice location

8540 S Sepulveda Blvd Ste 1002
Los Angeles, CA 90045-3808

Mailing address

8540 S Sepulveda Blvd
#1002
Los Angeles, CA 90045-3807
Phone (310) 670-2085

Other identifiers 1

IdentifierTypeStateIssuer
NMW972OtherCACALIF. NURSE MIDWIFE CERT

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090204000123 CA Practitioner - Certified Nurse Midwife (CNM) 5395809420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6041 Cadillac Ave
Los Angeles, CA 90034-1702
Phone (800) 954-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
972CAMDSkilled Nursing Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Nov 3, 2008 Accepting new patients
Airport-Playa Womens Medical Group a Medical Corporation CurrentSince Dec 5, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Nov 3, 2008 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

8540 S Sepulveda Blvd
Ste 1002
Los Angeles, CA 90045
Phone (310) 670-2085

393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1487670329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 S SEPULVEDA BLVD",
            "address_2": "#1002",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453807",
            "telephone_number": "310-670-2085",
            "fax_number": "310-670-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8540 S SEPULVEDA BLVD STE 1002",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453808",
            "telephone_number": "310-670-2085",
            "fax_number": "310-670-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KIM",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIF. NURSE MIDWIFE CERT",
            "identifier": "NMW972",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6041 Cadillac Ave",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900341702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.