Active NPI
William Donald Davidson, MD
- Otolaryngology Physician
- Fishersville, VA
National Provider Identifier
1033196415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 0101256478
- Practice address
- 70 Medical Center Cir Ste 211
Fishersville, VA 22939-2273 - Phone
- (540) 245-7010
- Fax
- (540) 245-7011
- NPI assigned
- Dec 28, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 059399 | GA | |
| Otolaryngology Physician | 207Y00000X | 25MA04977800 | NJ | |
| Otolaryngology Physician | 207Y00000X | 0101256478 | VA | Primary |
Addresses
Primary practice location
70 Medical Center Cir Ste 211
Fishersville, VA 22939-2273
Mailing address
PO Box 388
Fishersville, VA 22939-0388
Phone (540) 245-7010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 178202 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140922000283 | VA | Practitioner - Otolaryngology | 4486745882 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA04977800 | NJ | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of New Jersey Omb Centralized Payroll | Past | Accepting new patients |
Organizations & group practices 1
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.
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- Trenton, NJ
- NPI 1467552240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737590400000",
"number": "1033196415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 388",
"city": "FISHERSVILLE",
"state": "VA",
"postal_code": "229390388",
"telephone_number": "540-245-7010",
"fax_number": "540-245-7011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 MEDICAL CENTER CIR STE 211",
"city": "FISHERSVILLE",
"state": "VA",
"postal_code": "229392273",
"telephone_number": "540-245-7010",
"fax_number": "540-245-7011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "WILLIAM",
"middle_name": "DONALD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-28",
"last_updated": "2025-01-23",
"certification_date": "2025-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "GA",
"license": "059399",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NJ",
"license": "25MA04977800",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "VA",
"license": "0101256478",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "178202",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fishersville, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.