Individual provider Active NPI

Jessica Mi-Ohn Davis

  • Specialist
  • Bronx, NY
National Provider Identifier
1023747896
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
2440 Bronx Park E Apt F1
Bronx, NY 10467-7515
Phone
(347) 301-5585
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

2440 Bronx Park E Apt F1
Bronx, NY 10467-7515

Mailing address

2440 Bronx Park E Apt F1
Bronx, NY 10467-7515
Phone (347) 301-5585

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

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1023747896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 BRONX PARK E APT F1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104677515",
            "telephone_number": "347-301-5585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 BRONX PARK E APT F1",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104677515",
            "telephone_number": "347-301-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JESSICA",
        "middle_name": "MI-OHN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.