Active NPI
Angela M. Davis
- Other Technician
- Cambridge, OH
National Provider Identifier
1063574630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 2487063
- Practice address
- 216 S 12TH St
Cambridge, OH 43725-2417 - Phone
- (740) 584-5821
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Other Technician | 247200000X | 2487063 | OH | Primary |
Addresses
Primary practice location
216 S 12TH St
Cambridge, OH 43725-2417
Mailing address
216 S 12TH St
Cambridge, OH 43725-2417
Phone (740) 584-5821
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 303020591201 | Medicaid | OH |
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 |
|---|---|---|---|
| 2487063 | OH | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311638400000",
"number": "1063574630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 S 12TH ST",
"city": "CAMBRIDGE",
"state": "OH",
"postal_code": "437252417",
"telephone_number": "740-584-5821"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 S 12TH ST",
"city": "CAMBRIDGE",
"state": "OH",
"postal_code": "437252417",
"telephone_number": "740-584-5821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ANGELA",
"middle_name": "M.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2011-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "OH",
"license": "2487063",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "303020591201",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.