Individual provider Active NPI

Kimberly Davies-Robinet, PSY.D.

  • Psychologist
  • Oshkosh, WI
National Provider Identifier
1518151653
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3249-057 Issued in WI
Practice address
414 Doctors CT
Oshkosh, WI 54901-2065
Phone
(920) 303-5100
NPI assigned
Aug 31, 2007
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3249 WI
Clinical Psychologist 103TC0700X 1668 KY
Psychologist 103T00000X 3249-057 WI Primary

Addresses

Primary practice location

414 Doctors CT
Oshkosh, WI 54901-2065

Mailing address

700 N Westhaven Dr
Oshkosh, WI 54904-6947
Phone (920) 456-2030

Other practice location 1

700 N Westhaven Dr
Oshkosh, WI 54904-6947
Phone (920) 456-2030

Other identifiers 1

IdentifierTypeStateIssuer
100049219MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kdaviesrobinet169346@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20151113001547 WI Practitioner - Clinical Psychologist 1759567936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

855 N Westhaven Dr
Oshkosh, WI 54904-7668
Phone (920) 303-8700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3249-057WIMDPsychologist
3249WIMDDentist
1668KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. Current Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 9, 2015 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Nov 9, 2015 Accepting new patients

Locations

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643

414 Doctors Ct
Oshkosh, WI 54901
Phone (920) 303-5020

700 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 456-2030

Organizations & group practices 3

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": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1518151653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N WESTHAVEN DR",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549046947",
            "telephone_number": "920-456-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 DOCTORS CT",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549012065",
            "telephone_number": "920-303-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 N Westhaven Dr",
            "address_purpose": "LOCATION",
            "city": "Oshkosh",
            "state": "WI",
            "postal_code": "549046947",
            "country_code": "US",
            "telephone_number": "920-456-2030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIES-ROBINET",
        "first_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3249",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "1668",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "3249-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100049219",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdaviesrobinet169346@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "414 Doctors Ct",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549012065",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "414 Doctors Ct",
            "city": "Oshkosh",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549012065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oshkosh, WI

Sources for this page

Verify at the official NPI Registry.