Active NPI
Catherine A Davis
- Pediatrics Physician
- Mankato, MN
National Provider Identifier
1619956653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 37871
- Practice address
- 1400 E Madison Ave Ste 400a
Mankato, MN 56001-6805 - Phone
- (507) 625-1811
- NPI assigned
- Jan 10, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 37871 | MN | Primary |
Addresses
Primary practice location
1400 E Madison Ave Ste 400a
Mankato, MN 56001-6805
Mailing address
PO Box 8674
1230 E Main St Mankato Clinic LTD
Mankato, MN 56002-8674
Phone (507) 625-1811
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7K350DA | Other | MN | BCBS |
| 1202256 | Other | MN | MEDICA |
| NA2951023823 | Other | MN | PREFERRED ONE |
| 144719000 | Medicaid | MN | |
| 370005354 | Other | RR MEDICARE | |
| 0965525 | Other | IA | MEDICAID |
| 121155 | Other | MN | UCARE |
| HP25201 | Other | MN | HEALTH PARTNERS |
| 410849339 56001 C101 | Other | CHAMPUS | |
| 658425 | Other | MN | AMERICAS PPO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | catherinedavis@mklt.allscriptsdirect.net | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Mayo Medical School, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1230 Main St E
PO Box 8674
Mankato, MN 56002-8674
Phone (507) 625-1811
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mankato Clinic LTD | Pediatrics | Current | Accepting new patients |
Interoperability endpoints
- catherinedavis@mklt.allscriptsdirect.net
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594339200000",
"number": "1619956653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8674",
"address_2": "1230 E MAIN ST MANKATO CLINIC LTD",
"city": "MANKATO",
"state": "MN",
"postal_code": "560028674",
"telephone_number": "507-625-1811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E MADISON AVE STE 400A",
"city": "MANKATO",
"state": "MN",
"postal_code": "560016805",
"telephone_number": "507-625-1811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "CATHERINE",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-10",
"last_updated": "2020-07-10",
"certification_date": "2020-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "37871",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "7K350DA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "1202256",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "NA2951023823",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "144719000",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "370005354",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "0965525",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "121155",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP25201",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "410849339 56001 C101",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAS PPO",
"identifier": "658425",
"state": "MN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "catherinedavis@mklt.allscriptsdirect.net",
"affiliation": "N",
"endpointDescription": "Mankato Clinic Direct ID, Allscripts Community",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1400 E Madison Ave Ste 400A",
"city": "Mankato",
"state": "MN",
"country_code": "US",
"postal_code": "560016805",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.