KIMBERLY DIANE DAVIS (DO) – Family Medicine Physician, NPI 1639791379
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
826 FAMILY PRACTICE in CT
Provider Addresses for KIMBERLY DIANE DAVIS (DO)
130 HARTFORD ROAD
MANCHESTER, CT 06040
Phone: (860) 533-4679
Fax: (860) 645-4151
Type: Location
71 HAYNES ST
MANCHESTER, CT 060404131
Phone: (860) 533-4679
Fax: (860) 645-4151
Type: Mailing
13 CHURCH RD
EAST GRANBY, CT 060269406
Phone: (860) 653-4526
Fax: (833) 471-6186
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 30 Open Payments records for all available years, with a total value of $594.
Total Amount is formed as General ($594) + Research ($0) + Ownership ($0) = $594.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: PFIZER INC. ($154).
Total Amount
$594
General + Research + Ownership
Payments
30
Total payment records
General Amount
$594
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $154 |
| ABBVIE INC. | $153 |
| Exact Sciences Corporation | $119 |
| Novo Nordisk Inc | $48 |
| GlaxoSmithKline, LLC. | $27 |
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: 2024-03-12
PECOS data refreshed: 2026-06-15
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 |
|---|---|---|---|---|
| I20240312001142 | I | Family Practice | CT | 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 06040)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | CT | |
| - | CT | |
| Family Practice | CT | |
| Family Practice | CT | |
| - | CT | |
| Family Practice, Pediatric Medicine | CT | |
| Family Practice | CT | |
| - | CT | |
| - | CT | |
| - | CT |
Reviews
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