MR. KENNETH JOHN DAVIS (PA-C) – Medical Physician Assistant, NPI 1780714188
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,166 PHYSICIAN ASSISTANT in CO
Provider Addresses for MR. KENNETH JOHN DAVIS (PA-C)
2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND, CO 805389071
Phone: (970) 624-4128
Fax: (303) 258-7140
Type: Mailing
940 CENTRAL PARK DRIVE
SUITE 101
STEAMBOAT SPRINGS, CO 80487
Phone: (970) 879-1632
Fax: (970) 945-2893
Type: Location
595 Russell St
Craig, CO 81625
Phone: (970) 824-1020
Fax: (970) 824-5300
Type: Location
3001 S Lincoln Ave Ste A
Steamboat Springs, CO 804871790
Phone: (970) 875-2750
Type: Location
101 S FAIRFAX ST
DENVER, CO 802463135
Phone: (303) 993-2629
Fax: (303) 993-2934
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-08-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070828000909 | I | Physician Assistant | CO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 80538)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | CO | |
| Physician Assistant | CO | |
| Physician Assistant | CO | |
| Physician Assistant | IA | |
| Physician Assistant | CO | |
| Nurse Practitioner | CO | |
| Emergency Medicine | AZ | |
| Nurse Practitioner | NM | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | CO |
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