Patrick Davidson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

6112 Issued in GA

Practice address

314 Millers Branch Dr
Saint Marys, GA 31558-4164

Phone

(774) 413-0331

NPI assigned

Oct 17, 2007

Last updated

Nov 28, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Physicians Inc

  dba Emergency Resource Group

  • Emergency Medicine Physician
  • Brunswick, GA
  • NPI 1477001972
  Medicare reassignment
• Georgia Emergency Associates

  • Emergency Medicine Physician
  • Rincon, GA
  • NPI 1528098290
  Medicare reassignment
• Advanced Pediatric Specialists LLC

  • Pediatrics Physician
  • Savannah, GA
  • NPI 1073046397
  NPD (past)

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1063601839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 MILLERS BRANCH DR",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315584164",
            "telephone_number": "774-413-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 MILLERS BRANCH DR",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315584164",
            "telephone_number": "774-413-0331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Ansel Hallet Rd",
            "address_2": "Suite A",
            "address_purpose": "LOCATION",
            "city": "West Yarmouth",
            "state": "MA",
            "postal_code": "026732582",
            "country_code": "US",
            "telephone_number": "508-771-4263",
            "fax_number": "508-771-7906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "PATRICK",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-17",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "2389",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "6112",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "2389",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Cunningham
• Charma Lou Dalope, NP
• Harsh Trikambhai Dangaria, M.D.
• Breanna Darnell, BSN, RN
• Robert Burton Davenport-Ray, APRN
• Chatham Davis Jr., SOCIAL WORKER
• Kaelynn Davis
• Grant Christopher Degravelle, DPT, PT
• Nicole D Demick
• Anushka Adil Desai

• Medical Physician Assistant in Saint Marys, GA
• Providers in Saint Marys, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.