Individual provider Active NPI

Kathleen Kay Davis, APRN

  • Adult Health Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1780219998
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
11006109 Issued in FL
Practice address
611 Druid Rd E Ste 511
Clearwater, FL 33756-3942
Phone
(727) 601-4007
NPI assigned
Mar 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 11006109 FL Primary

Addresses

Primary practice location

611 Druid Rd E Ste 511
Clearwater, FL 33756-3942

Mailing address

601 S Harbour Island Blvd Ste 200
Tampa, FL 33602-5925
Phone (800) 480-5243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200319000045 FL Practitioner - Nurse Practitioner 3678901071 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Medical Associates LLCGroup PAC ID 0648271155, 162 clinicians

Practice addresses (Care Compare)

611 Druid Rd E
Suite 511
Clearwater, FL 33756-3942
Phone (727) 601-4007

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11006109FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Health Care of Pinellas Inc. CurrentSince Mar 10, 2020 Accepting new patients
Professional Health Care of Pinellas LLC CurrentSince Mar 10, 2020 Accepting new patients
Florida Medical Associates LLC CurrentSince Sep 9, 2024 Accepting new patients

Locations

611 Druid Rd E
Ste 511
Clearwater, FL 33756
Phone (727) 442-0500

13940 N US Highway 441
Ste 102
Lady Lake, FL 32159
Phone (352) 509-9900

1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054

601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kathleen.davis@sl.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/EIJHAA

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1583625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1780219998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025925",
            "telephone_number": "800-480-5243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 DRUID RD E STE 511",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563942",
            "telephone_number": "727-601-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KATHLEEN",
        "middle_name": "KAY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-08",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11006109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.