NPIMap

Individual provider Active NPI

Kendra M Davis, MD

  • Family Medicine Physician
  • Newport, PA
National Provider Identifier
1669433470
Registry record updated Jan 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD069404L Issued in PA
Practice address
300 Bretz CT Ste 100
Newport, PA 17074-8615
Phone
(717) 567-3174
Fax
(717) 703-0018
NPI assigned
Mar 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD069404L PA Primary

Addresses

Primary practice location

300 Bretz CT Ste 100
Newport, PA 17074-8615

Mailing address

300 Bretz CT Ste 100
Newport, PA 17074-8615

Other identifiers 1

IdentifierTypeStateIssuer
001772601MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kdavis6807@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031212000845 PA Practitioner - Family Practice 9032016696 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Temple University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

300 Bretz CT
Newport, PA 17074-8614
Phone (717) 567-3174

Hospital & facility affiliations

  • Residential Home Health of Carlisle, LLC Home health agency, Mechanicsburg, PA, CCN 397047
  • Homeland Homehealth Home health agency, Harrisburg, PA, CCN 398270
  • Accentcare Home Health of Central Pennsylvania Home health agency, Elizabethtown, PA, CCN 398062
  • Homeland Hospice Hospice, Harrisburg, PA, CCN 391714
  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067
  • Upmc Carlisle Hospital, Carlisle, PA, CCN 390058
  • Geisinger-Lewistown Hospital Hospital, Lewistown, PA, CCN 390048
  • St Lukes Hospital Hospital, Bethlehem, PA, CCN 390049

Merit-based Incentive Payment System (MIPS)

Final score
86.08 of 100Reported as group
Quality
76.48
Promoting interoperability
100
Improvement activities
40
Cost
77.12

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD069404LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Regional Physicians Family Medicine CurrentSince May 31, 2022 Accepting new patients
Pinnacle Health Medical Services CurrentSince Aug 16, 1999 Accepting new patients
Pinnacle Health Medical Services CurrentSince Aug 16, 1999 Accepting new patients
Pinnacle Health Medical Services Family Medicine Current Accepting new patients
Pinnacle Health Regional Physicians Family Medicine CurrentSince May 31, 2022 Accepting new patients
Pinnacle Health Medical Services Past Accepting new patients

Locations

210 Forge Rd
Boiling Springs, PA 17007
Phone (717) 249-8300

1533 Commerce Ave
Ste 2
Carlisle, PA 17015
Phone (717) 796-9300

2645 N 3rd St
Harrisburg, PA 17110
Phone (717) 782-4650

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

506 S State Rd
Marysville, PA 17053
Phone (717) 957-2212

300 Bretz Ct
Ste 100
Newport, PA 17074
Phone (717) 567-3174

300 Bretz Ct
Newport, PA 17074
Phone (717) 567-3174

Interoperability endpoints

  • Direct secure messaging: kdavis538008@upmc.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611360000000",
    "number": "1669433470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BRETZ CT STE 100",
            "city": "NEWPORT",
            "state": "PA",
            "postal_code": "170748615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BRETZ CT STE 100",
            "city": "NEWPORT",
            "state": "PA",
            "postal_code": "170748615",
            "telephone_number": "717-567-3174",
            "fax_number": "717-703-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KENDRA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2021-01-23",
        "certification_date": "2021-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD069404L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001772601",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdavis6807@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "300 Bretz Ct Ste 100",
            "city": "Newport",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170748615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newport, PA

Sources for this page

Verify at the official NPI Registry.