Active NPI
Jena Alley Davidson, LPTA
- Physical Therapy Assistant
- Radford, VA
National Provider Identifier
1063101707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2306605901
- Practice address
- 700 Randolph St
Radford, VA 24141 - Phone
- (540) 633-6538
- NPI assigned
- May 8, 2023
- Last updated
- May 8, 2023
- 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 Therapy Assistant | 225200000X | 2306605901 | VA | Primary |
Addresses
Primary practice location
700 Randolph St
Radford, VA 24141
Mailing address
115 Talus LN NW Apt 205
Christiansburg, VA 24073
Phone (276) 733-3334
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2306605901 | VA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683504000000",
"number": "1063101707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 TALUS LN NW APT 205",
"city": "CHRISTIANSBURG",
"state": "VA",
"postal_code": "24073",
"telephone_number": "276-733-3334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 RANDOLPH ST",
"city": "RADFORD",
"state": "VA",
"postal_code": "24141",
"telephone_number": "540-633-6538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "JENA",
"middle_name": "ALLEY",
"credential": "LPTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-08",
"last_updated": "2023-05-08",
"certification_date": "2023-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "VA",
"license": "2306605901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Radford, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.