Paige Elise Kingman

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95005216 Issued in CA

Practice address

160 Gateway Dr
#110
Lincoln, CA 95648-3317

Phone

(916) 434-1623

Fax

(916) 434-1625

NPI assigned

Dec 7, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Paige Elise Davenport Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1720522824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 GATEWAY DR",
            "address_2": "#110",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956483317",
            "telephone_number": "916-434-1623",
            "fax_number": "916-434-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 GATEWAY DR",
            "address_2": "#110",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956483317",
            "telephone_number": "916-434-1623",
            "fax_number": "916-434-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGMAN",
        "first_name": "PAIGE",
        "middle_name": "ELISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95005216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAIGE",
            "last_name": "DAVENPORT",
            "middle_name": "ELISE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Trenton Keeler, PHARMD
• David Russell Keelor, P.T.
• Brian Patrick Keller, D.P.M
• Lynne G. Kelly, L.M.F.T.
• Taylor Keomuangtai
• Kathy Y. Koh, MD
• Barbara Michelle Kokkonen, D.C.
• Jenna Kopp
• Irina Korman Dolomis, M.D.
• Mark Dylan Kovar

• Family Nurse Practitioner in Lincoln, CA
• Providers in Lincoln, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; 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.