Active NPI
Karen Marisa Davidson
- Developmental Therapist
- Worcester, MA
National Provider Identifier
1003291626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- 92813207
- Practice address
- 345 Greenwood St Ste a
Suite B
Worcester, MA 01607-1767 - Phone
- (508) 363-0200
- NPI assigned
- Jul 24, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | 92813207 | VT | Primary |
Addresses
Primary practice location
345 Greenwood St Ste a
Suite B
Worcester, MA 01607-1767
Mailing address
17 Paris Ave
Worcester, MA 01603-1659
Phone (203) 376-4982
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 92813207 | VT | MD | Developmental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437696000000",
"number": "1003291626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 PARIS AVE",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016031659",
"telephone_number": "203-376-4982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 GREENWOOD ST STE A",
"address_2": "SUITE B",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016071767",
"telephone_number": "508-363-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "KAREN",
"middle_name": "MARISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-24",
"last_updated": "2015-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "VT",
"license": "92813207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.