Kimberly Crisp Davis I
Specialist in Syracuse, NY. Individual provider (NPI-1).
NPI number1295278331
StatusActive
Last updated in NPPESNov 21, 2016
Details
- NPI
- 1295278331
- Entity type
- Individual (NPI-1)
- Name
- Kimberly Crisp Davis I
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 21, 2016
- Last updated
- Nov 21, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | NY | Yes |
Practice location
171 Intrepid LnSyracuse, NY 13205-2548
Phone 315-724-4286
Mailing address
92 Jca RdHastings, NY 13076-3152
Phone 315-720-2364
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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