1942523030 NPI number — KATHRYN M DAVIS ARNP

Table of content: KATHRYN M DAVIS ARNP (NPI 1942523030)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942523030 NPI number — KATHRYN M DAVIS ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAVIS
Provider First Name:
KATHRYN
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DAVIS
Provider Other First Name:
KAY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1942523030
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 SPRING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JEFFERSONVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47130-3554
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-282-1888
Provider Business Mailing Address Fax Number:
812-218-9318

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 SPRING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JEFFERSONVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47130-3554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-282-1888
Provider Business Practice Location Address Fax Number:
812-218-9318
Provider Enumeration Date:
03/04/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  3006500 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 71003200A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 50029506 . This is a "PASSPORT" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1487872636 . This is a "RAILROAD GROUP NUMBER ARNP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 82900176 . This is a "MEDICAID THERAPY GROUP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 2444451000 . This is a "PASSPORT GROUP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 78903689 . This is a "MEDICAID ARNP GROUP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: P00830158 . This is a "RAILROAD MEDICARE #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000653631 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6764 . This is a "MEDICARE GROUP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 100386460 . This is a "MEDICAID GROUP" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 160780 . This is a "MEDICARE GROUP" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 160860 . This is a "MEDICARE GROUP" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 200977990 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7100113360 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: CG2274 . This is a "MEDICARE RAILROAD GROUP" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: P00830157 . This is a "RAILROAD MEDICARE #" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000056294 . This is a "ANTHEM GROUP #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50704000 . This is a "MAGELLAN GROUP MIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 65927857 . This is a "MEDICAID GROUP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com