KELLEY ANNE DAVIDSON (APRN) – Family Nurse Practitioner, NPI 1164283578

KELLEY ANNE DAVIDSON (APRN) is a healthcare provider. based in Henryetta, Oklahoma. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 1234 (OK). The NPI Number for KELLEY ANNE DAVIDSON (APRN) is 1164283578

Main info

Female
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
KELLEY ANNE DAVIDSON (APRN)
NPI
1164283578
Phone
Not provided
Address
401 W MAIN ST
Enumeration Date
22 January 2024
Last Update Date
6 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9187272790
Graduation Year
2023 (3 years ago)
PAC ID
1254878523
Group Practice PAC ID
8820410970
Professional Enrollment ID
I20240805000846
Address ID
OK740129641BR1095XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:2State licenses:1Digital endpointsOther names

3,299 NURSE PRACTITIONER in OK

Provider Addresses for KELLEY ANNE DAVIDSON (APRN)

  • 401 W MAIN ST

    HENRYETTA, OK 744374241

    Phone:

    Mailing address matches the actual address.

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: 2024-08-05

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
I20240805000846INurse PractitionerOKTBD

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 74437)

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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: 8820410970View full group profile
NameSpecialtyState
Nurse PractitionerOK
Nurse PractitionerOK
Physician AssistantOK
Nurse PractitionerOK
Physician AssistantOK
Nurse PractitionerOK
Physician AssistantOK
Physician AssistantOK
Nurse PractitionerOK
Nurse PractitionerOK

Reviews

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Frequently asked questions

Is there an official ID for KELLEY ANNE DAVIDSON (APRN) in U.S. healthcare records?
The official identifier for KELLEY ANNE DAVIDSON (APRN) is NPI 1164283578.
Would KELLEY ANNE DAVIDSON (APRN) appear as active to a payer?
You can treat KELLEY ANNE DAVIDSON (APRN) as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to KELLEY ANNE DAVIDSON (APRN)?
KELLEY ANNE DAVIDSON (APRN)'s specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is KELLEY ANNE DAVIDSON (APRN) located near Henryetta?
KELLEY ANNE DAVIDSON (APRN) currently maps to Henryetta, Oklahoma in this extract.
Can I trust this NPI listing for KELLEY ANNE DAVIDSON (APRN)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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