Individual provider Active NPI

Kim-Oanh H. Davis, MASTERS DEGREE

  • Audiologist
  • Goose Creek, SC
National Provider Identifier
1891953733
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2228 Issued in SC
Practice address
119 Springhall Dr
Suite C
Goose Creek, SC 29445-5368
Phone
(843) 329-0785
Fax
(843) 329-0790
NPI assigned
May 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2228 SC Primary

Addresses

Primary practice location

119 Springhall Dr
Suite C
Goose Creek, SC 29445-5368

Mailing address

119 Springhall Dr
Suite C
Goose Creek, SC 29445-5368
Phone (843) 329-0785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081028000083 SC Practitioner - Qualified Audiologist 4486712932
I20221121002230 GA Practitioner - Qualified Audiologist 4486712932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Ear Nose and Throat, LLCGroup PAC ID 7810040698, 4 clinicians

Practice addresses (Care Compare)

322 Commercial Dr
Suite 2
Savannah, GA 31406-3639
Phone (912) 355-2335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Ear Nose & Throat, LLC Audiologist CurrentSince Oct 5, 2022 Accepting new patients
Coastal Ear Nose & Throat, LLC PastSince Oct 5, 2022 Accepting new patients
Lifestyle Hearing Corporation USA Inc. Audiologist PastSince May 1, 2021 Accepting new patients

Locations

200 Blue Moon Xing
Ste 3
Pooler, GA 31322

200 Blue Moon Xing
Ste 103
Pooler, GA 31322
Phone (912) 355-2335

322 Commercial Dr
Ste 2
Savannah, GA 31406
Phone (912) 355-2335

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.

NPI Registry JSON

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

{
    "created_epoch": "1211932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1891953733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 SPRINGHALL DR",
            "address_2": "SUITE C",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455368",
            "telephone_number": "843-329-0785",
            "fax_number": "843-329-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 SPRINGHALL DR",
            "address_2": "SUITE C",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294455368",
            "telephone_number": "843-329-0785",
            "fax_number": "843-329-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KIM-OANH",
        "middle_name": "H.",
        "name_prefix": "Mrs.",
        "credential": "MASTERS DEGREE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-28",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "SC",
            "license": "2228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goose Creek, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.