KIMBERLY DIANE DAVIS DO
NPI 1639791379
Family Medicine in East Granby, CT

Q: What is Kimberly Davis's NPI number?

The NPI number for Kimberly Davis is 1639791379. It was assigned to this individual provider in the NPPES registry on May 15, 2020.

Q: What is Kimberly Davis's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kimberly Davis was last updated on January 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 15, 2020PECOS EnrolledAccepts Medicare Assignment

13 CHURCH RD, EAST GRANBY, CT 06026(860) 653-4526(833) 471-6186 Get Directions Write a Review

NPPES record last updated: January 23, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Kimberly Diane Davis Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY DIANE DAVIS DO (NPI 1639791379) is an individual family medicine provider in East Granby, Connecticut, licensed in Connecticut (75672) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS and is a graduate of Alabama College Of Osteopathic Medicine (2020).

NPPES Registry Identity

NPI1639791379

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameKIMBERLY DIANE DAVISCredential: DO

Location Address13 CHURCH RDEast Granby, CT 06026-9406

Mailing Address71 Haynes StManchester, CT 06040-4131 · (860) 533-4679 · Fax (860) 645-4151

Phone(860) 653-4526

Fax(833) 471-6186

Sole ProprietorNo

Medical School CMSAlabama College Of Osteopathic MedicineGraduated 2020

Enumeration DateMay 15, 2020

Last NPPES UpdateJanuary 23, 2025

NPPES CertifiedJanuary 23, 2025

✔ NPI 1639791379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CT · 75672

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

13 CHURCH RD, East Granby, CT 06026

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kimberly Diane Davis Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42656142

PECOS Enrollment IDI20240312001142

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Davis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

East Granby Family Practice LLC

Same address

Family Medicine

13 CHURCH RD
East Granby, CT 06026

Reassigned Medicare billing, Connecticut enrollment
13 clinicians in this Medicare group

NPI 1154308229 (860) 653-4526

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

57 services51 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

52 services40 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

43 services37 patients

Annual alcohol misuse screening, 5 to 15 minutes G0442

An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.

15 services15 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

14 services14 patients

Annual depression screening, 5 to 15 minutes G0444

An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.

14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06026 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$93.86 typical visit price

range $60.82 – $183.10

Typical copayment $23.46 (range $15.20 – $45.77)

Most-billed visit code 99203

Established Patient

$106.68 typical visit price

range $19.76 – $149.26

Typical copayment $26.67 (range $4.94 – $37.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEVEN R DIETERICH MD

Family Medicine