Healthcare Provider Details

I. General information

NPI: 1225669021
Provider Name (Legal Business Name): SHELBI DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2020
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S US HIGHWAY 169
SMITHVILLE MO
64089-9317
US

IV. Provider business mailing address

601 S US HIGHWAY 169
SMITHVILLE MO
64089-9317
US

V. Phone/Fax

Practice location:
  • Phone: 816-532-3999
  • Fax: 816-532-4465
Mailing address:
  • Phone: 816-532-3999
  • Fax: 816-532-4465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2024031073
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: