Kathleen Davis, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN068065 Issued in GA

Practice address

120 Oakside CT
Canton, GA 30114-2471

Phone

(678) 880-8770

NPI assigned

Jul 7, 2015

Last updated

Oct 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northside Anesthesiology Consultants, LLC

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1083600308
  NPD (past)
• Northside Hospital, Inc.

  dba Northside Gwinnett Joan Glancy

  • Rehabilitation Hospital Unit
  • Duluth, GA
  • NPI 1134168016
  NPD (past)

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1750764932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2765 LAWRENCE MILL RUN",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300683158",
            "telephone_number": "678-777-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 OAKSIDE CT",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301142471",
            "telephone_number": "678-880-8770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Johnson Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421605",
            "country_code": "US",
            "telephone_number": "404-785-4848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KATHLEEN",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-07",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN068065",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "GA",
            "license": "RN068065",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David L Selden PC (Etowah Chiropractic Clinic)
• Megan Davidson, DMD
• Angela Doreen Davis
• Ashley Nicole Davis
• George Gregory Davis, B.S., D.C.
• Rebekah Davis, RN
• Marie E Dawson, OT
• Jessica Day, NP
• Uma T Daya, P.A.
• Days of Hope Counseling

• Family Nurse Practitioner in Canton, GA
• Providers in Canton, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; 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.