Active NPI
Kimberly Anne Davis, DC, ART
- Sports Physician Chiropractor
- Austin, TX
National Provider Identifier
1538307764
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 12008
- Practice address
- 2305 Donley Dr Ste 106
Austin, TX 78758-4535 - Phone
- (512) 266-1000
- Fax
- (512) 597-0898
- NPI assigned
- Jan 26, 2009
- Last updated
- Jul 27, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | 8980 | AZ | |
| Sports Physician Chiropractor | 111NS0005X | 12008 | TX | Primary |
Addresses
Primary practice location
2305 Donley Dr Ste 106
Austin, TX 78758-4535
Mailing address
3310 W Braker LN BLDG 2-300
Austin, TX 78758-7854
Phone (512) 266-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, AZ
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12008 | TX | MD | Social Worker |
| 8980 | AZ | MD | Physical Therapist |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1538307764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3310 W BRAKER LN BLDG 2-300",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787587854",
"telephone_number": "512-266-1000",
"fax_number": "512-597-0898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2305 DONLEY DR STE 106",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787584535",
"telephone_number": "512-266-1000",
"fax_number": "512-597-0898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KIMBERLY",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "DC, ART",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-26",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor, Rehabilitation",
"state": "AZ",
"license": "8980",
"primary": false
},
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "TX",
"license": "12008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.