KELLEY DAVIS, D.O., P.A. (NPI# 1477589059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477589059 |
| Entity Type | Organization |
| Organization Name | KELLEY DAVIS, D.O., P.A. |
| Practice Address |
1251a E Red Bird Ln Dallas TX 75241-2008 |
| Practice Telephone | 2143070827 |
| Practice Fax Number | 2143070927 |
| Mailing Telephone | 2143070827 |
| Mailing Fax Number | 2143070927 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2007-11-30 |
| Authorized Official Name | KELLEY MICHELLE DAVIS (PRESIDENT) |
| Authorized Official Telephone | 2143740827 |
| Authorized Official Credential | D.O |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | L8319 | TX | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | CAQH | 11568320 | 01 |
| Street Address |
1251A E RED BIRD LN |
| City | DALLAS |
| State | TX |
| Zip Code | 75241-2008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609833771 | Kelley Michelle Davis | Family Medicine | 1251a E Red Bird Ln, Dallas, TX 75241-2008 | 2006-05-01 |
| 1730115288 | Tamika L Perry, D.o., P.a. | Specialist | 1251a E Red Bird Ln, Dallas, TX 75241-2008 | 2006-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649888777 | Sonya Williams | Licensed Practical Nurse | 3481 Pinebrock Dr, Dallas, TX 75241 | 2020-07-15 |
| 1346700259 | Angel Vales | Counselor | 5520 Langdon Rd, Dallas, TX 75241 | 2019-03-25 |
| 1144708611 | Brandie L Mccray | Counselor | 155 Idlewheat Ln, Dallas, TX 75241 | 2018-08-06 |
| 1649792144 | Jessica Franco Skinner | Social Worker | 5520 Langdon Rd., Suite B, C/o Wilmer Hutchins Youth and Family Center, Dallas, TX 75241 | 2017-07-17 |
| 1659790756 | Michele S Gomez | Technician | 3984 Texas College Drive, Dallas, TX 75241 | 2014-04-16 |
| 1013223494 | Jennifer Peterson | Assisted Living Facility | 4160 Clark College Dr., Dallas, TX 75241 | 2010-08-24 |
| 1447561394 | Tricia Davis | Social Worker | 1568 Sax Leigh Dr, Dallas, TX 75241 | 2010-06-25 |
| 1871804989 | Sonya Williams | Case Management | 3481pinebrook Dr, Dallas, TX 75241 | 2010-06-24 |
| 1144468414 | Edwin Ng | Dentist | 1500 E Langdon Rd, Dallas, TX 75241 | 2009-01-26 |
| 1578709135 | Lynita Teresa Fisher | Registered Nurse | 1244 Serenade Lane, Dallas, TX 75241 | 2008-12-31 |
| Find all providers in zip 75241 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275172827 | Tina Mone Patterson | Specialist | 8501 Old Hickory Trl Apt 2106, Dallas, TX 75237-3821 | 2019-12-31 |
| 1225670862 | Camerin J Cole | Specialist | 4701 Haverwood Ln Apt 112, Dallas, TX 75287-4206 | 2019-10-15 |
| 1356833198 | Diana Denise Demasi | Specialist | 4411 Lemmon Ave Ste 102, Dallas, TX 75219-2390 | 2018-06-06 |
| 1942718242 | Kristy Prieto | Specialist | 18809 Lina St Apt 10209, Dallas, TX 75287-2519 | 2018-01-21 |
| 1306354600 | Johnneshia Donald | Specialist | 3702 Frankford Rd Apt 12303, Dallas, TX 75287-7808 | 2018-01-21 |
| 1841740404 | Surgical Associates of Dallas | Specialist | 621 N Hall St Ste 520, Dallas, TX 75226-1315 | 2016-10-07 |
| 1194198101 | Surepoint Emergency Physicians Denton, Pllc | Specialist | 5005 Lbj Fwy, Suite 1200, Dallas, TX 75244 | 2015-11-12 |
| 1316329071 | Southern Spine Institute Pllc | Specialist | 11970 N Central Expy Ste 450, Dallas, TX 75243-3787 | 2015-06-18 |
| 1760886345 | Wls Surgical Associates of North Texas Pllc | Specialist | 7777 Forest Ln Ste C400, Dallas, TX 75230-7516 | 2014-10-10 |
| 1952731804 | Aw Sleep Diagnostic Center Inc | Specialist | 13154 Coit Road, Suite 105, Dallas, TX 75240-5787 | 2013-11-13 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.