Active NPI
McKenzie Lynn Davis
- Student in an Organized Health Care Education/Training Program
- Moscow, ID
National Provider Identifier
1881487254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 875 Perimeter Dr
Moscow, ID 83844-9803 - Phone
- (208) 885-6772
- NPI assigned
- May 27, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
875 Perimeter Dr
Moscow, ID 83844-9803
Mailing address
618 Bryden Ave
1/2
Lewiston, ID 83501
Phone (509) 381-9701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748390400000",
"number": "1881487254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "618 BRYDEN AVE",
"address_2": "1/2",
"city": "LEWISTON",
"state": "ID",
"postal_code": "83501",
"telephone_number": "509-381-9701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 PERIMETER DR",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838449803",
"telephone_number": "208-885-6772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MCKENZIE",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-27",
"last_updated": "2025-05-28",
"certification_date": "2025-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.