Kimberly Davis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

94-01142 Issued in NC

Practice address

1655 Wake Drive
Ste 101
Wake Forest, NC 27587

Phone

(919) 556-4779

Fax

(919) 556-5277

NPI assigned

Jun 30, 2005

Last updated

Jul 8, 2007By 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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberlydavis@wfpapllc.allscriptsdirect.net

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.

• Wake Forest Pediatric Associates, PLLC

  • Pediatrics Physician
  • Wake Forest, NC
  • NPI 1790782126
  Medicare reassignment NPD
• Wake Forest Pediatric Associates, PLLC

  dba WFPA, PLLC - Knightdale Pediatric Office

  • Pediatrics Physician
  • Knightdale, NC
  • NPI 1790973469
  NPD

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649277120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11108 LAKESHORE DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276135908",
            "telephone_number": "919-518-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 WAKE DRIVE",
            "address_2": "STE 101",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "27587",
            "telephone_number": "919-556-4779",
            "fax_number": "919-556-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KIMBERLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "94-01142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8919210",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Daugherty, M.D.
• Natalie Pearl David, PMHNP
• Elise Davis
• Elizabeth Kidd Davis, PT, DPT
• Jasmine Davis, MS, CCC-SLP
• Paige Huguely Davis, CCC-SLP
• Rachel Laurel Davis, PT, DPT
• Stephen Davis, CLINICAL COUNSELOR
• Tameka Elaine Davis
• Tyler Matheson Davis, DDS

• Pediatrics Physician in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.