Active NPI
Jessie Davidson, OT
- Occupational Therapist
- Whiteville, NC
National Provider Identifier
1053754945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 108 Memory PLZ
Whiteville, NC 28472-2640 - Phone
- (910) 642-0500
- Fax
- (910) 642-9282
- NPI assigned
- Apr 10, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
108 Memory PLZ
Whiteville, NC 28472-2640
Mailing address
108 Memory PLZ
Columbus Physical Therapy
Whiteville, NC 28472-2640
Phone (910) 642-0500
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": "1365552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365552000000",
"number": "1053754945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 MEMORY PLZ",
"address_2": "COLUMBUS PHYSICAL THERAPY",
"city": "WHITEVILLE",
"state": "NC",
"postal_code": "284722640",
"telephone_number": "910-642-0500",
"fax_number": "910-642-9282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 MEMORY PLZ",
"city": "WHITEVILLE",
"state": "NC",
"postal_code": "284722640",
"telephone_number": "910-642-0500",
"fax_number": "910-642-9282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "JESSIE",
"name_prefix": "Mr.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-10",
"last_updated": "2013-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whiteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.