Individual provider Active NPI

Kathy J. Davis, PHD, ATC, CSCS

  • Athletic Trainer
  • Cambridge, MA
National Provider Identifier
1659369007
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
11 Issued in MA
Practice address
77 Massachusetts Ave
W35-115
Cambridge, MA 02139-4301
Phone
(617) 253-4908
NPI assigned
Oct 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 11 MA Primary
Athletic Trainer 2255A2300X 8 NH

Addresses

Primary practice location

77 Massachusetts Ave
W35-115
Cambridge, MA 02139-4301

Mailing address

16 Paul Ave
Derry, NH 03038-3803
Phone (603) 425-6335

Other identifiers 1

IdentifierTypeStateIssuer
2255A2300XOtherMAATHLETIC TRAINING SERVICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
11MAMDAthletic Trainer
8NHMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1659369007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 PAUL AVE",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030383803",
            "telephone_number": "603-425-6335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 MASSACHUSETTS AVE",
            "address_2": "W35-115",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021394301",
            "telephone_number": "617-253-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KATHY",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "PHD, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "11",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NH",
            "license": "8",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINING SERVICE",
            "identifier": "2255A2300X",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.