Kevin Davis, PA
Individual provider Active NPI Medical Physician Assistant · Hindman, KY
NPI 1811903529 · NPPES record last updated Nov 12, 2024
Key facts
- NPI
- 1811903529
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA244 (KY)
- Practice address
- 396 Highway 899
Hindman, KY 41822-8953 - Phone
- (606) 785-9440
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 30
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Mountain Comprehensive Health Corporation
Practice addresses (Care Compare)
226 Medical Plaza LN
Whitesburg, KY 41858-7425
Phone (606) 633-4871
464 Ky Hwy 699
Cornettsville, KY 41731-8749
Phone (606) 476-2593
72 Buckhorn Clinic Rd
Buckhorn, KY 41721-8936
Phone (606) 398-7141
Hospital & facility affiliations
- Hazard Arh Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040311001104 | KY | Practitioner - Physician Assistant | 8527976687 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA244 | KY | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mountain Comprehensive Health Corporation | Current |
Accepting new patients | |
| Mountain Comprehensive Health Corporation | Current |
Accepting new patients | |
| Mountain Comprehensive Health Corporation | Current | Accepting new patients | |
| Appalachian Regional Healthcare, Inc | Past | Accepting new patients | |
| Our Lady of the Way Hospital, Inc | Past | Accepting new patients | |
| Mountain Comprehensive Health Corporation | Past | Accepting new patients | |
| Team Radiology Physicians, PA | Past | Accepting new patients |
Locations
464 KY Highway 699
Cornettsville, KY 41731
Phone (606) 476-2450
396 Highway 899
Hindman, KY 41822
Phone (606) 785-0208
105 Isom Plz
Jeremiah, KY 41826
Phone (606) 633-2233
324 Medical Plaza Ln
Whitesburg, KY 41858
Phone (606) 633-4871
226 Medical Plaza Ln
Whitesburg, KY 41858
Phone (606) 633-4871
Interoperability endpoints
- kevin.davis.p1@direct.mtncomp.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA244 | KY | Yes |
Addresses
Primary practice location
396 Highway 899
Hindman, KY 41822-8953
Mailing address
70 Holly Hills Mall Rd
Hindman, KY 41822-9121
Phone (606) 785-9440
Other practice location 1
70 Holly Hills Mall Rd
Hindman, KY 41822-9121
Phone (606) 785-9440
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95002440 | Medicaid | KY |
Other providers in Hindman, KY
- Melissa Candis Collett
- Kristen Danielle Combs
- Cornerstone Community Health
- Justin Taylor Cornett
- Whitney Brooke Cornett
- Zachary Davis
- Dustin Combs PLLC
- East Kentucky Health Service
- East Kentucky Pharmacy Inc
- East Ky Health Service Center
All providers in Hindman, KY · Medical Physician Assistant in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.