Active NPI
Ellen Pauline Davidson, DPT
- Physical Therapist
- Beavercreek, OH
National Provider Identifier
1033728126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT018683
- Practice address
- 2587 Commons Blvd Ste 120
Beavercreek, OH 45431-3841 - Phone
- (937) 426-5555
- Fax
- (940) 381-2253
- NPI assigned
- Jul 24, 2020
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT018683 | OH | Primary |
Addresses
Primary practice location
2587 Commons Blvd Ste 120
Beavercreek, OH 45431-3841
Mailing address
1200 Corporate Dr Ste 400
Birmingham, AL 35242-5424
Phone (423) 541-5492
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT018683 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595548800000",
"number": "1033728126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 CORPORATE DR STE 400",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352425424",
"telephone_number": "423-541-5492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2587 COMMONS BLVD STE 120",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "454313841",
"telephone_number": "937-426-5555",
"fax_number": "940-381-2253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "ELLEN",
"middle_name": "PAULINE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-24",
"last_updated": "2020-07-24",
"certification_date": "2020-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT018683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beavercreek, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.