Kim Marie Davidson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

FLME0056564 Issued in FL

Practice address

23476 W US Highway 27
High Springs, FL 32643

Phone

(386) 454-0568

Fax

(352) 224-7899

NPI assigned

Oct 11, 2005

Last updated

Jul 10, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1568450773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23343 NW COUNTY ROAD 236",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "326439669",
            "telephone_number": "386-454-0698",
            "fax_number": "386-454-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23476 W US HIGHWAY 27",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "32643",
            "telephone_number": "386-454-0568",
            "fax_number": "352-224-7899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4707 NW 53rd Ave",
            "address_2": "#B",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326534805",
            "country_code": "US",
            "telephone_number": "352-337-9900",
            "fax_number": "352-372-9459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4707 NW 53rd Ave",
            "address_2": "#B",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326534805",
            "country_code": "US",
            "telephone_number": "352-337-9900",
            "fax_number": "352-372-9459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "KIM",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "FLME0056564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "68502",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in High Springs, FL
• Providers in High Springs, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.