McKenzie Brooke Davis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA0000004507 Issued in TN

Practice address

1120 Perimeter Park Dr
Cookeville, TN 38501-0922

Phone

(931) 528-0002

Fax

(931) 528-1515

NPI assigned

Jan 26, 2021

Last updated

Aug 23, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.74 of 100Reported as group

Quality

99.48

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mckenzie@cookevilledermatology.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lisa M Whiteaker, MD

  • Dermatology Physician
  • Cookeville, TN
  • NPI 1306811427
  Medicare reassignment
• Lisa Whiteaker MD

  • Medical Specialty Clinic/Center
  • Cookeville, TN
  • NPI 1043895659
  NPD

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1912597675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E SPRING ST APT NN2",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014508",
            "telephone_number": "931-239-5239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 PERIMETER PARK DR",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010922",
            "telephone_number": "931-528-0002",
            "fax_number": "931-528-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MCKENZIE",
        "middle_name": "BROOKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "PA0000004507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greg Davis, BS
• Hunter Davis
• James Williams Davis, MD
• Jennifer B Davis, PHARM.D.
• Justin Davis, PMHNP
• Miranda Kathleen Davis, RBT
• Passionate Shinese Davis, PMHNP-BC
• Zachary Boyd Davis
• Mallory Dawson, DMD
• Sara Iris Debovis, NP

• Medical Physician Assistant in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.