NPIMap

Individual provider Active NPI

Jason Davis, PA-C

  • Physician Assistant
  • Keene, NH
National Provider Identifier
1023632205
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1635 Issued in NH
Practice address
580 Court St
Keene, NH 03431-1718
Phone
(603) 354-5400
NPI assigned
Jun 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1635 NH Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

580 Court St
Keene, NH 03431-1718

Mailing address

590 Court St
Keene, NH 03431-1719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201102002213 NH Practitioner - Physician Assistant 7517377583 Reassigns benefits to 3 organizations
I20230823003976 CT Practitioner - Physician Assistant 7517377583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians
Cheshire Medical CenterGroup PAC ID 1456260165, 165 clinicians

Practice addresses (Care Compare)

1 Blachley Rd
Stamford, CT 06902-0002
Phone (212) 774-7598

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

580 Court St
Keene, NH 03431-1718
Phone (603) 354-5454

Hospital & facility affiliations

  • Cheshire Medical Center Hospital, Keene, NH, CCN 300019
  • Hospital for Special Surgery Hospital, New York, NY, CCN 330270
  • Stamford Hospital Hospital, Stamford, CT, CCN 070006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1635NHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ny Society for the Relief of Ruptured & Crippled Maintaining CurrentSince Aug 4, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Sep 2, 2020 Accepting new patients
Cheshire Medical Center CurrentSince Sep 2, 2020 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Sep 3, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Sep 2, 2020 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Sep 2, 2020 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Sep 3, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital Past Accepting new patients
Cheshire Medical Center Past Accepting new patients

Locations

1 Blachley Rd
Stamford, CT 06902
Phone (203) 705-0750

276 Post Rd W
Westport, CT 06880
Phone (203) 391-2270

590 Court St
Keene, NH 03431
Phone (603) 354-5454

580 Court St
Keene, NH 03431
Phone (603) 354-5454

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Interoperability endpoints

  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
  • Direct secure messaging: jdavis403536@direct.dartmouth-hitchcock.org
  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1023632205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 COURT ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 COURT ST",
            "city": "KEENE",
            "state": "NH",
            "postal_code": "034311718",
            "telephone_number": "603-354-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JASON",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1635",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keene, NH

Sources for this page

Verify at the official NPI Registry.