Jerome Alfred Davis, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

60-100430 Issued in NY

Practice address

101 Broad St
Plattsburgh, NY 12901-2637

Phone

(518) 564-2187

Fax

(518) 564-2188

NPI assigned

Apr 10, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003039975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 COOPER DR",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129015302",
            "telephone_number": "518-561-4791",
            "fax_number": "518-564-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BROAD ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129012637",
            "telephone_number": "518-564-2187",
            "fax_number": "518-564-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JEROME",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "60-100430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin A Davidson, M.D.
• Nancy Beth Davidson, RN
• Eileen E Davis Roesler, MS CCCA
• Barbara Davis-Meconi, R.N.
• Gordon H Davis, DMD,DMSC
• Kelly L Davis, PT
• Robert Earle Davis
• Donald W. Davison, D.D.S.
• Jennifer Mercier De Goey, P.T.
• James L De Lucas, M.D.

• Specialist in Plattsburgh, NY
• Providers in Plattsburgh, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.