Kenley Brent Davis, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME94305 Issued in FL

Practice address

17222 Hospital Blvd
Suite 326
Brooksville, FL 34601-8925

Phone

(352) 544-6145

Fax

(352) 688-9189

NPI assigned

Aug 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Howard University College of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tampa General Medical Group IncGroup PAC ID 7416253828, 353 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tampa General Hospital Brooksville Hospital, Brooksville, FL, CCN 100071

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: kenley.davis.1@4692.direct.athenahealth.com
• FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
• Direct secure messaging: kdavis300994@direct.tgh.org

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.

• Tampa General Medical Group Inc

  • Surgery Physician
  • Tampa, FL
  • NPI 1043557853
  Medicare reassignment Care Compare group NPD
• Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1124558929
  NPD
• Tampa General Medical Group Inc

  • Cardiovascular Disease Physician
  • Sun City Center, FL
  • NPI 1144910316
  NPD
• Tampa General Medical Group Inc

  • Internal Medicine Physician
  • Trinity, FL
  • NPI 1962819250
  NPD
• Tampa General Medical Group Inc

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1164769063
  NPD (past)

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

• Tampa General Hospital Hernando LLC

  • General Acute Care Hospital
  • Brooksville, FL
  • NPI 1063294197
  Care Compare affiliation
• Tampa General Hospital Hernando, LLC

  • General Acute Care Hospital
  • Spring Hill, FL
  • NPI 1275305013
  Care Compare affiliation

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664755200000",
    "number": "1841303559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17222 HOSPITAL BLVD STE 242",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346018925",
            "telephone_number": "352-544-6145",
            "fax_number": "352-688-9189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17222 HOSPITAL BLVD",
            "address_2": "SUITE 326",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346018925",
            "telephone_number": "352-544-6145",
            "fax_number": "352-688-9189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KENLEY",
        "middle_name": "BRENT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME94305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "30162Y",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274800200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30162",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kenley.davis.1@4692.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct address",
            "address_1": "17222 Hospital Blvd",
            "address_2": "Suite 326",
            "city": "Brooksville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346018925",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Moreno PLLC
• Judy Ann David, LMHC
• Shannon Nicole Davie, APRN
• Adam James Davies, CRNA
• Keri Lynn Davies, ARNP-C
• Stehpen B Davis, B.S.
• Ian Allen Dawkins
• Dawn Wever, LMHC
• Rafael De la Riva, MD
• Lara Dedmon

• Surgery Physician in Brooksville, FL
• Providers in Brooksville, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.