MRS. KIMBERLY MICHEL DAVIS (AGACNP) – Nursing Care Agency, NPI 1063052470

MRS. KIMBERLY MICHEL DAVIS (AGACNP) is a healthcare provider. based in Sugar hill, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials AGACNP. They hold a License No. RN256254 (GA). The NPI Number for MRS. KIMBERLY MICHEL DAVIS (AGACNP) is 1063052470

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KIMBERLY MICHEL DAVIS (AGACNP)
NPI
1063052470
Phone
(470) 214-9756
Address
500 WAGON HILL LN
Enumeration Date
14 January 2020
Last Update Date
21 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7702196000
Graduation Year
2024 (2 years ago)
PAC ID
4486181161
Group Practice PAC ID
6901898386
Professional Enrollment ID
I20241218004270
Address ID
GA305175600BR1400XPLXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:6State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for MRS. KIMBERLY MICHEL DAVIS (AGACNP)

  • 500 WAGON HILL LN

    SUGAR HILL, GA 305188034

    Phone: (470) 214-9756

    Fax: (470) 201-1303

    Type: Mailing

  • 4560 ATWATER CT STE 105-2

    BUFORD, GA 305183497

    Phone: (470) 214-9756

    Fax: (470) 201-1303

    Type: Location

  • PO BOX 742616

    ATLANTA, GA 303742616

    Phone: (770) 219-8420

    Type: Mailing

  • 1400 RIVER PL

    BRASELTON, GA 305175600

    Phone: (770) 848-8000

    Type: Location

  • 500 Wagon Hill Ln

    Sugar Hill, GA 305188034

    Phone: (470) 214-9756

    Fax: (470) 201-1303

    Type: Location

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: 2024-12-18

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241218004270INurse PractitionerGATBD

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.

Verify on CMS Revalidation Lookup Tool

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 30518)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6901898386View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YGA
-GA
-GA
A N E S T H E S I O L O G YGA
-GA
-GA
Physician AssistantGA
Nurse PractitionerGA
Surgical Oncology, General SurgeryNJ
Pulmonary DiseaseNY

Reviews

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Frequently asked questions

How do I look up MRS. KIMBERLY MICHEL DAVIS (AGACNP) by NPI?
Use NPI 1063052470 when you need to reference MRS. KIMBERLY MICHEL DAVIS (AGACNP) in forms, claims, or directories.
Does this profile mean MRS. KIMBERLY MICHEL DAVIS (AGACNP) is currently active?
Yes — MRS. KIMBERLY MICHEL DAVIS (AGACNP) appears active in the national provider directory.
Does MRS. KIMBERLY MICHEL DAVIS (AGACNP) list a primary specialty?
If you are matching referrals, note Nursing Care Agency for MRS. KIMBERLY MICHEL DAVIS (AGACNP). Clinical services aligned with this taxonomy classification.
What location shows for MRS. KIMBERLY MICHEL DAVIS (AGACNP)?
We surface Sugar Hill, Georgia for MRS. KIMBERLY MICHEL DAVIS (AGACNP) based on available NPPES addresses.
What if Sugar Hill, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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