Kathleen Davis
Individual provider Active NPI Physician Assistant · Chamblee, GA
NPI 1982244364 · NPPES record last updated Oct 9, 2024
Key facts
- NPI
- 1982244364
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 9595 (GA)
- Practice address
- 3182 Shallowford Rd NE
Chamblee, GA 30341-3640 - Phone
- (770) 457-5758
- NPI assigned
- Jan 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 10
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Medical University of South Carolina College of Medicine, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Emory Clinic Inc
Practice addresses (Care Compare)
1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (404) 778-7525
Hospital & facility affiliations
- Emory University Hospital
- Emory University Hospital Midtown
Merit-based Incentive Payment System (MIPS)
- Final score
- 94.51 of 100
- Quality
- 80.61
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210402000154 | GA | Practitioner - Physician Assistant | 6103233465 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9595 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Servicio Medico Hispano | Family Medicine | Current |
Accepting new patients |
| The Emory Clinic Inc | Hematology & Oncology | Current |
Accepting new patients |
Locations
1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525
2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193
Interoperability endpoints
- kbenedict33958@direct.emory.org
- https://fhir4.healow.com/fhir/r4/AAHDCD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9595 | GA | Yes |
Addresses
Primary practice location
3182 Shallowford Rd NE
Chamblee, GA 30341-3640
Mailing address
3182 Shallowford Rd NE
Chamblee, GA 30341-3640
Phone (770) 457-5758
Other practice location 1
1942 Beaver Ruin Rd
Norcross, GA 30071-3828
Phone (770) 674-0501
Other providers in Chamblee, GA
- Shanna Cox
- Elizabeth Cranford
- M'Kenzie Cravens
- Denise A. Daisy
- Danwantry Medical & Imaging Services, LLC
- Megan Dawes
- DCN1, LLC
- Dekalb Community Service Board
- Dekalb Community Service Board
- Dekalb Community Service Board
All providers in Chamblee, GA · Physician Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.