Active NPI
Kathleen Carol Davis, FNP
- Family Nurse Practitioner
- Des Moines, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A152354
- Practice address
- 1200 University Ave Ste 120
Des Moines, IA 50314-2355 - Phone
- (515) 248-1500
- Fax
- (515) 248-1510
- NPI assigned
- May 10, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209017602 | IL | |
| Family Nurse Practitioner | 363LF0000X | A152354 | IA | Primary |
Addresses
Primary practice location
1200 University Ave Ste 120
Des Moines, IA 50314-2355
Mailing address
1200 University Ave Ste 200
Des Moines, IA 50314-2355
Phone (515) 248-1447
Other practice location 1
1555 N Sandburg Ter Apt 412
Chicago, IL 60610-1335
Phone (773) 738-8942
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209017602 | IL | MD | Nurse Practitioner |
| A152354 | IA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Health Care, Inc. | Current | Accepting new patients | |
| Primary Health Care, Inc. | Current | Accepting new patients |
Locations
3509 E 29th St
Des Moines, IA 50317
Phone (515) 248-1600
1200 University Ave
Ste 200
Des Moines, IA 50314
Phone (515) 248-1447
1200 University Ave
Ste 120
Des Moines, IA 50314
Phone (515) 248-1500
2353 SE 14th St
Des Moines, IA 50320
Phone (515) 248-1400
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CBABCD/Endpoint/CBABCD
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Des Moines, IA
- NPI 1497522262
-
- Federally Qualified Health Center (FQHC)
- Des Moines, IA
- NPI 1588692487
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539302400000",
"number": "1548750045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 UNIVERSITY AVE STE 200",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503142355",
"telephone_number": "515-248-1447",
"fax_number": "515-248-1440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 UNIVERSITY AVE STE 120",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503142355",
"telephone_number": "515-248-1500",
"fax_number": "515-248-1510"
}
],
"practiceLocations": [
{
"address_1": "1555 N Sandburg Ter Apt 412",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606101335",
"country_code": "US",
"telephone_number": "773-738-8942",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "KATHLEEN",
"middle_name": "CAROL",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-10",
"last_updated": "2018-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209017602",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IA",
"license": "A152354",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.