MRS. KENISHA DAVIS (APRN) – Family Nurse Practitioner, NPI 1033604954
Family Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MRS. KENISHA DAVIS (APRN)
18232, Ridgewood Avenue, Lansing, Thornton Township, Cook County, Illinois, 60438, United States
LANSING, IL 604383024
Phone: (708) 655-1482
Type: Mailing
1393 BRANDYWINE RD # 1393
CROWN POINT, IN 463079307
Phone: (708) 655-1482
Type: Mailing
16266 PRINCE DR
SOUTH HOLLAND, IL 604733233
Phone: (708) 222-7333
Fax: (708) 221-0501
Type: Location
PO BOX 528
128 S EAST ST
CROWN POINT, IN 463074030
Phone: (708) 655-1482
Type: Mailing
1251 N EDDY ST
SOUTH BEND, IN 466171479
Phone: (219) 999-2045
Fax: (219) 300-5795
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: 2023-04-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20190107001480 | I | Nurse Practitioner | IN | TBD |
| I20230420002760 | I | Nurse Practitioner | AZ | 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 60438)
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