KEITH DAVIDSON (NP-C) – Adult Health Nurse Practitioner, NPI 1366827982

KEITH DAVIDSON (NP-C) is a healthcare provider. based in Deckerville, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials NP-C. They hold a License No. 4704274292 (MI). The NPI Number for KEITH DAVIDSON (NP-C) is 1366827982

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
KEITH DAVIDSON (NP-C)
NPI
1366827982
Phone
(810) 376-3100
Address
3532 MAIN ST
Enumeration Date
24 July 2015
Last Update Date
16 November 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8103762885
Graduation Year
2015 (11 years ago)
PAC ID
0547575953
Group Practice PAC ID
2163508821
Professional Enrollment ID
I20150813011934
Address ID
MI484277703DE3559XSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:10State licenses:1Digital endpointsOther names

8,105 NURSE PRACTITIONER in MI

Provider Addresses for KEITH DAVIDSON (NP-C)

  • 3532 MAIN ST

    DECKERVILLE, MI 484279615

    Phone: (810) 376-3100

    Fax: (810) 376-8311

    Type: Location

  • PO BOX 126

    3532 MAIN STREET

    DECKERVILLE, MI 484270126

    Phone: (810) 376-3100

    Fax: (810) 376-8311

    Type: Mailing

  • 2433 BLACK RIVER ST

    DECKERVILLE, MI 484279425

    Phone: (810) 376-2885

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 18 Open Payments records for all available years, with a total value of $337.

Total Amount is formed as General ($337) + Research ($0) + Ownership ($0) = $337.

Last reported payment date: 2024-06-18 • Largest payer in this snapshot: USWM, LLC ($88).

Total Amount

$337

General + Research + Ownership

Payments

18

Total payment records

General Amount

$337

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2015-08-13

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
I20150813011934INurse PractitionerMITBD

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 48427)

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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: 2163508821View full group profile
NameSpecialtyState
Emergency Medicine, Hospitalist, Emergency Medicine, Internal MedicineMI
-IN
Emergency MedicineMI
Nurse PractitionerMI
Nurse PractitionerMI
Internal Medicine, Family PracticeMI
Internal MedicineMI
Nurse PractitionerMI
Internal MedicineMI
Emergency MedicineMI

Reviews

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Frequently asked questions

Does KEITH DAVIDSON (NP-C) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KEITH DAVIDSON (NP-C) uses 1366827982.
Does the file indicate KEITH DAVIDSON (NP-C) is practicing under active NPI?
Directory data currently reports KEITH DAVIDSON (NP-C) as active.
What taxonomy line describes KEITH DAVIDSON (NP-C)?
For research purposes, treat KEITH DAVIDSON (NP-C) as Adult Health Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect KEITH DAVIDSON (NP-C) on a map?
Expect Deckerville, Michigan as a primary anchor for KEITH DAVIDSON (NP-C) unless the record lists multiple sites.
Is the information about KEITH DAVIDSON (NP-C) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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