Kenyatta Dashawn Davis, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN.139100.MEDS-IV Issued in OH

Practice address

1201 Champlain St
Toledo, OH 43604-1907

Phone

(567) 316-7253

NPI assigned

Jan 2, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Empowered for Excellence Behavioral Health Ohio

  • Community/Behavioral Health Agency
  • Toledo, OH
  • NPI 1336538206
  NPD (past)

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514851200000",
    "number": "1710494547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3222 WEST CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "43606",
            "telephone_number": "567-316-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 CHAMPLAIN ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041907",
            "telephone_number": "567-316-7253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KENYATTA",
        "middle_name": "DASHAWN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-02",
        "last_updated": "2018-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.139100.MEDS-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Alan Davis, D.C.
• John M Davis, LSW
• Joseph M Davis II
• Kara Joy Davis, LPN
• Kenneth D Davis, QMHS
• Kimberly Anne Davis
• Kirk R. Davis, D.O.
• Kristen Marie Davis
• Laura E Davis, CNP
• Liesa A Davis, NP-C

• Licensed Practical Nurse in Toledo, OH
• Providers in Toledo, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2018; 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.