Kyle Stone Davis, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT015779 Issued in GA

Practice address

500 Spring St SE Ste 101
Gainesville, GA 30501-3773

Phone

(770) 615-7676

Fax

(770) 615-0177

NPI assigned

Feb 22, 2022

Last updated

Mar 23, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kyle Lee Whitaker Former name

Electronic endpoints 1

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

• Lifting Spirits Therapy Services, Inc

  • Pediatric Occupational Therapist
  • Gainesville, GA
  • NPI 1083891907
  NPD (past)

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1760137483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SPRING ST SE STE 101",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013773",
            "telephone_number": "770-615-7676",
            "fax_number": "770-615-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SPRING ST SE STE 101",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013773",
            "telephone_number": "770-615-7676",
            "fax_number": "770-615-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KYLE",
        "middle_name": "STONE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "841619876",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://app.clinicsource.com/ClinicPortal/login.aspx?ReturnUrl=%2fClinicPortal%3fclinicname%3dliftingspiritstherapy&clinicname=liftingspiritstherapy",
            "affiliation": "N",
            "endpointDescription": "ClinicSource",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 Spring St SE Ste 101",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KYLE",
            "last_name": "WHITAKER",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher M Davis
• Gary Davis III, MD
• James Ross Davis, ATC
• Jennifer Davis, NP-C
• Katie Lynn Davis, ATC/L
• Logoi B Davis, PA
• Margaret Alisa Davis, MD
• Michelle M Davis, AGACNP-BC
• Mitchell Gordon Davis, MD
• Shelley S Davis, CRNA

• Physical Therapist in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.