Katelyn Brooke Davis, CPNP-AC

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

120595 Issued in AR

Practice address

1 Childrens Way # 512-12
Little Rock, AR 72202-3500

Phone

(501) 364-1341

Fax

(501) 364-4082

NPI assigned

Oct 10, 2024

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 AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Arkansas Childrens Hospital

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1598773079
  Medicare reassignment NPD
• Arkansas Childrens Professional Services Organization LLC

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1629889464
  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1346230968
  Medicare reassignment NPD
• Arkansas Children'S Hospital

  • Children's Hospital
  • Little Rock, AR
  • NPI 1477561983
  NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • El Dorado, AR
  • NPI 1023795051
  NPD
• University of Arkansas for Medical Sciences

  • Psychologist
  • Little Rock, AR
  • NPI 1114255353
  NPD
• Arkansas Childrens Hospital

  • Dental Clinic/Center
  • Little Rock, AR
  • NPI 1770889552
  NPD (past)
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016
  NPD (past)

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1982424420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 653",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1100",
            "fax_number": "501-364-4082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS WAY # 512-12",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023500",
            "telephone_number": "501-364-1341",
            "fax_number": "501-364-4082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KATELYN",
        "middle_name": "BROOKE",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-10",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "AR",
            "license": "120595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Davis, MHPP
• Johnny Davis, LPC
• Jordan Hunter Davis
• Juanita Faye Davis, RN
• Kaitlyn Davis, QBHP
• Katina Davis
• Kelly Davis
• Koesha Davis
• Kristen Davis
• Kristen Canby Davis, LCSW

• Critical Care Pediatric Nurse Practitioner in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Critical Care Pediatric Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.