Active NPI
Kaisha Davis
- Clinical Social Worker
- Orem, UT
National Provider Identifier
1952076267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 13432043-3502
- Practice address
- 901 S Orem Blvd
Orem, UT 84058-5011 - Phone
- (801) 960-9622
- Fax
- (801) 373-0639
- NPI assigned
- Aug 10, 2021
- Reactivated
- Apr 17, 2024
- Last updated
- Apr 18, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 13432043-3502 | UT | Primary |
Addresses
Primary practice location
901 S Orem Blvd
Orem, UT 84058-5011
Mailing address
750 N Freedom Blvd
Provo, UT 84601-1677
Phone (801) 373-4760
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13432043-3502 | UT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713398400000",
"number": "1952076267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 N FREEDOM BLVD",
"city": "PROVO",
"state": "UT",
"postal_code": "846011677",
"telephone_number": "801-373-4760",
"fax_number": "801-373-0639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 S OREM BLVD",
"city": "OREM",
"state": "UT",
"postal_code": "840585011",
"telephone_number": "801-960-9622",
"fax_number": "801-373-0639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KAISHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-10",
"last_updated": "2024-04-18",
"certification_date": "2024-04-18",
"deactivation_date": "2024-03-19",
"reactivation_date": "2024-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "13432043-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.