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Deactivated NPI 1386109775 Deactivated / Inactive NPI Female Practitioner

Kelli Davis

Dietitian, Registered • Yucaipa, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Kelli Davis has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 10, 2019
NPI Deactivation Date February 11, 2020
Total Practice Duration ~1 Years of Practice (2019 – 2020)

Professional Overview & Biography Verified Profile Summary

Kelli Davis was a registered Dietitian, Registered practicing in Yucaipa, CA. Throughout an active medical career spanning 1 years, Kelli Davis provided care at the practice location at 33859 KING DR until profile deactivation on 2020-02-11.

Practice Location & Contact Primary Location

Practice Address

33859 King Dr

Yucaipa, CA 923996980

Telephone 9513239074

Specialty Benchmarks & Practice Insights

Comparative analytics for Dietitian, Registered in Yucaipa, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.6 Yrs
Regional Practice Density
4 Specialists

Practicing in Yucaipa, CA (7235 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dietitian, Registered Primary Specialty

NUCC Taxonomy Code: 133V00000X

State License None 963183

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 11, 2020

Record deactivated on February 11, 2020

NPI Profile Active February 10, 2019

NPI status registered as active in NPPES database

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Updated Practice Location February 10, 2019

Registered at 33859 KING DR, YUCAIPA, CA 923996980 (Tel: 9513239074)

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Updated Business Mailing Address February 10, 2019

Registered at PO BOX 11116, SAN BERNARDINO, CA 924231116 (Tel: 9513239074)

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Provider Name / Credentials Updated February 10, 2019

Recorded as KELLI DAVIS

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 10, 2019

Dietitian, Registered (License #963183 in None)

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Initial NPI Registration & Enumeration February 10, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1386109775
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 10, 2019
Last Update: February 10, 2019
Deactivation Date: February 11, 2020

Mailing Address

Po Box 11116

San Bernardino, CA 924231116

Phone: 9513239074

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.