Organization Active NPI

Kayla Davidson, LLC

  • Clinical Psychologist
  • West Des Moines, IA
National Provider Identifier
1629797576
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
KAYLA DAVIDSON, LLC
Practice address
950 Office Park Rd Ste 306
West Des Moines, IA 50265-2548
Phone
(515) 859-8412
NPI assigned
Aug 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Authorized official

Name
Kayla Davidson, PSY.D.NPI 1801129572
Title
Psychologist
Phone
(515) 859-8412

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

950 Office Park Rd Ste 306
West Des Moines, IA 50265-2548

Mailing address

950 Office Park Rd Ste 306
West Des Moines, IA 50265-2548
Phone (515) 859-8412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220929000585 IA Part B Supplier - Clinic/Group Practice 6709262751 Receives reassigned benefits from 1 practitioner
Practice locations: West Des Moines, IA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1629797576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 OFFICE PARK RD STE 306",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652548",
            "telephone_number": "515-859-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 OFFICE PARK RD STE 306",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502652548",
            "telephone_number": "515-859-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAYLA DAVIDSON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-24",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "515-859-8412",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.

Verify at the official NPI Registry.