Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1699715888 Individual Practitioner Male Practitioner

Dr. Larry Davis , MD

Pediatrics • Kenosha, WI

Professional Overview & Biography Verified Profile Summary

Dr. Larry Davis, MD is a registered healthcare professional specializing in Pediatrics in Kenosha, WI. Practice services are available at 6809 122ND AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6809 122nd Ave

Kenosha, WI 531427335

Telephone 2626548633
Fax 2626545467
Associated Practice Facility / Clinic
🏢 Children's Medical Group Facility NPI 1740455096

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Kenosha, WI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 30.0 Yrs
State Avg: 18.1 Yrs
Regional Practice Density
20 Specialists

Practicing in Kenosha, WI (1245 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

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License WI 69544-20

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License IL 036-104343

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1699715888 (WI)
Medicaid State Provider ID
036104343 (IL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
NPI 1023003373

Doctor of Medicine (M.D.)

NPI 1194710129

Doctor of Medicine (M.D.)

Sarah Melton

Social Worker - Clinical

NPI 1285125476
NPI 1295876647

Doctor of Medicine (M.D.)

NPI 1326033671

Doctor of Medicine (M.D.)

Mehwish Aqueel , MSC, LPC, NCC

Counselor - Professional

NPI 1497234256

Master of Science, Licensed Professional Counselor, National Certified Counselor

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Practice Location February 01, 2019

Registered at 6809 122ND AVE, KENOSHA, WI 531427335 (Tel: 2626548633)

📍
Updated Practice Location January 11, 2019

Registered at 6125 GREEN BAY RD STE 700, KENOSHA, WI 531422928 (Tel: 2626548633)

📍
Updated Business Mailing Address January 11, 2019

Registered at 9000 W WISCONSIN AVE # MS 958, MILWAUKEE, WI 532264874 (Tel: 4142667615)

NPI Profile Active August 02, 2010

NPI status registered as active in NPPES database

📍
Updated Practice Location August 02, 2010

Registered at 1900 HOLLISTER DR, SUITE 330, LIBERTYVILLE, IL 600483713 (Tel: 8473622500)

📍
Updated Business Mailing Address August 02, 2010

Registered at 1900 HOLLISTER DR, SUITE 330, LIBERTYVILLE, IL 600483713 (Tel: 8473622500)

👤
Provider Name / Credentials Updated August 02, 2010

Recorded as LARRY DAVIS, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 02, 2010

Pediatrics (License #036-104343 in IL)

🟢
Initial NPI Registration & Enumeration June 07, 2006

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: 1699715888
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 07, 2006
Last Update: February 01, 2019
Sole Proprietor: No

Mailing Address

9000 W Wisconsin Ave # Ms 958

Milwaukee, WI 532264874

Phone: 4142667615

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.