Individual provider Active NPI

Kevin K Davis Jr., PA-C

  • Physician Assistant
  • Billings, MT
National Provider Identifier
1972019925
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60686 Issued in MT
Practice address
2900 12TH Ave N Saint Vincent Heart Institute
Suite 204E
Billings, MT 59101
Phone
(406) 237-5001
Fax
(406) 237-5010
NPI assigned
Dec 28, 2017
Last updated
Jun 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 60686 MT Primary

Addresses

Primary practice location

2900 12TH Ave N Saint Vincent Heart Institute
Suite 204E
Billings, MT 59101

Mailing address

2900 12TH Ave N Saint Vincent Heart Institute
Suite 204E
Billings, MT 59101
Phone (406) 237-3690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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

Enrollment IDStateProvider typePAC IDDetails
I20180131002049 MT Practitioner - Physician Assistant 3577823046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1233 N 30TH St
Billings, MT 59101-0127
Phone (406) 237-3913

16 N Miles Ave
Suite 101
Hardin, MT 59034-2356
Phone (406) 237-8270

2900 12TH Ave N
Suite 204E
Billings, MT 59101-7502
Phone (406) 237-5001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
60686MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
SCL Health Medical Group - Billings, LLC CurrentSince Jan 1, 2022 Accepting new patients
SCL Health Medical Group - Billings LLC CurrentSince Jan 1, 2022 Accepting new patients
SCL Health Medical Group - Billings LLC Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

1233 N 30th St
Billings, MT 59101
Phone (406) 237-3850

2900 12th Ave N
Ste 204E
Billings, MT 59101
Phone (406) 237-5001

16 N Miles Ave
Hardin, MT 59034
Phone (406) 665-2205

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1972019925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 12TH AVE N SAINT VINCENT HEART INSTITUTE",
            "address_2": "SUITE 204E",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "59101",
            "telephone_number": "406-237-3690",
            "fax_number": "406-237-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 12TH AVE N SAINT VINCENT HEART INSTITUTE",
            "address_2": "SUITE 204E",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "59101",
            "telephone_number": "406-237-5001",
            "fax_number": "406-237-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KEVIN",
        "middle_name": "K",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-28",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "60686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.