Individual provider Active NPI

Kristin E Davidson, APRN

  • Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1720462633
Registry record updated Nov 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN001991 Issued in NV
Practice address
6850 N Durango Dr Ste 204
Las Vegas, NV 89149-4596
Phone
(702) 867-1726
Fax
(702) 396-0245
NPI assigned
Jul 10, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN001991 NV Primary

Addresses

Primary practice location

6850 N Durango Dr Ste 204
Las Vegas, NV 89149-4596

Mailing address

8906 Spanish Ridge Ave Ste 202
Las Vegas, NV 89148-1319
Phone (702) 330-3102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20150818006067 NV Practitioner - Nurse Practitioner 7719292887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Nevada School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

517 Rose St
Las Vegas, NV 89106-4020
Phone (702) 438-4692

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN001991NVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Health Associates of Southern Nevada- Martin, PLLC CurrentSince Jun 1, 2016 Accepting new patients
Women'S Health Associates of Southern Nevada- Martin, PLLC CurrentSince Jun 1, 2016 Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients

Locations

517 Rose St
Las Vegas, NV 89106
Phone (702) 366-1206

6850 N Durango Dr
Ste 202
Las Vegas, NV 89149
Phone (702) 867-1726

9120 W Post Rd
Ste 200
Las Vegas, NV 89148
Phone (702) 255-2022

8906 Spanish Ridge Ave
Ste 202
Las Vegas, NV 89148
Phone (702) 330-3102

6850 N Durango Dr
Ste 204
Las Vegas, NV 89149
Phone (702) 791-7855

Interoperability endpoints

  • Direct secure messaging: kristin.davidson@whasn.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605312000000",
    "number": "1720462633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8906 SPANISH RIDGE AVE STE 202",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481319",
            "telephone_number": "702-330-3102",
            "fax_number": "702-912-4994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 N DURANGO DR STE 204",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891494596",
            "telephone_number": "702-867-1726",
            "fax_number": "702-396-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "KRISTIN",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-10",
        "last_updated": "2020-11-14",
        "certification_date": "2020-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN001991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.