Joel I. Davidson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2431 Issued in NV

Practice address

1550 Tuscano CT
Henderson, NV 89052-4142

Phone

(702) 736-1200

Fax

(702) 736-6538

NPI assigned

Apr 11, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Robert Marriott Medical Corp

  dba Advantage Wound Care

  • Surgery Physician
  • El Segundo, CA
  • NPI 1083883938

  NV

  Medicare reassignment
• J Davidson MD

  • Point of Service
  • Henderson, NV
  • NPI 1023476876
  NPD (past) Authorized official

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501718400000",
    "number": "1053535377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 TUSCANO COURT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89052",
            "telephone_number": "702-736-1200",
            "fax_number": "702-736-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 TUSCANO CT",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524142",
            "telephone_number": "702-736-1200",
            "fax_number": "702-736-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "JOEL",
        "middle_name": "I.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2017-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "2431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20-02097",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David S. Gothelf, a Professional Corporation (Desert Family Medicine of Green Valley)
• David T Chan MD Professional Corporation
• Roxanne Denise David, DMD
• James R Davidson, MD
• Jennifer Lynn Davidson, MA
• Kellie Anne Davidson, AU.D.
• Lauren Davidson
• Marisa Davidson
• Cyanea Davies, LAT, ATC
• Josefina Davila Lopez

• Surgery Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Surgery Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2017; 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.

Verify at the official NPI Registry.