Active NPI
Kathe Kristin Davis, PT
- Physical Therapist
- Pueblo, CO
National Provider Identifier
1689875486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3879
- Practice address
- 511 W 29TH St
Pueblo, CO 81008-1128 - Phone
- (719) 545-1900
- NPI assigned
- May 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3879 | CO | Primary |
Addresses
Primary practice location
511 W 29TH St
Pueblo, CO 81008-1128
Mailing address
4305 St Andrews Dr
Pueblo, CO 81001-1164
Phone (719) 544-8771
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3879 | CO | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1689875486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4305 ST ANDREWS DR",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810011164",
"telephone_number": "719-544-8771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 W 29TH ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810081128",
"telephone_number": "719-545-1900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KATHE",
"middle_name": "KRISTIN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-30",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "3879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.