Kimberly F Davis, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

901603 Issued in MS

Practice address

120 Fountains Blvd
Madison, MS 39110-6343

Phone

(769) 300-0700

Fax

(601) 990-2180

NPI assigned

Oct 18, 2016

Last updated

Dec 8, 2022By 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 3

Other names 1

• Kim Davis Other name

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: kim.davis@40481587920900.direct.elationemr.com

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1699226399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SHERBORNE PL",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328959",
            "telephone_number": "601-421-9537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 FOUNTAINS BLVD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106343",
            "telephone_number": "769-300-0700",
            "fax_number": "601-990-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KIMBERLY",
        "middle_name": "F",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-18",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "901603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "901603",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP CERT",
            "identifier": "F06161208",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "R867828",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "DAVIS",
            "credential": "NP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Anne Marie Currie Hreish
• Summer Curry
• Dandelion Pediatric Therapy, LLC
• Martha Rainey Daniels, PMHNP-BC
• Alexis Davis, LIFESTYLE COACH
• Zachery Hunter Davis, PHARMD
• Sydney Dawkins, FNP
• Julie Brewer Dawson
• DCC, MD, PLLC
• Howard D Dear, M.D.

• Nurse Practitioner in Madison, MS
• Providers in Madison, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.