Deborah Davidson, MSN, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

71007149A Issued in IN

Practice address

405 Fairgrounds Rd
Tipton, IN 46072-9596

Phone

(765) 408-0536

Fax

(765) 405-0539

NPI assigned

Sep 8, 2014

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Four County Comprehensive Mental Health Center IncGroup PAC ID 2163334277, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Four County Comprehensive Mental Health Center Inc

  dba 4C Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Peru, IN
  • NPI 1972545945
  Medicare reassignment Care Compare group NPD
• Four County Comprehensive Mental Health Center, Inc

  dba 4C Health

  • Psychiatric Hospital
  • Peru, IN
  • NPI 1457539751
  NPD

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063813178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FULTON ST",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471577",
            "telephone_number": "574-205-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 FAIRGROUNDS RD",
            "city": "TIPTON",
            "state": "IN",
            "postal_code": "460729596",
            "telephone_number": "765-408-0536",
            "fax_number": "765-405-0539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1948 W Boulevard",
            "address_purpose": "LOCATION",
            "city": "Kokomo",
            "state": "IN",
            "postal_code": "469026078",
            "country_code": "US",
            "telephone_number": "765-452-5437",
            "fax_number": "844-684-6185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 E 8th St",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "IN",
            "postal_code": "469751443",
            "country_code": "US",
            "telephone_number": "574-223-8586",
            "fax_number": "574-223-8786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 E 8th St",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "IN",
            "postal_code": "469751443",
            "country_code": "US",
            "telephone_number": "574-223-8565",
            "fax_number": "574-223-8786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2701 17th St",
            "address_purpose": "LOCATION",
            "city": "Rock Island",
            "state": "IL",
            "postal_code": "612015351",
            "country_code": "US",
            "telephone_number": "309-779-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 N Broadway Ste A",
            "address_purpose": "LOCATION",
            "city": "Peru",
            "state": "IN",
            "postal_code": "469701070",
            "country_code": "US",
            "telephone_number": "765-472-1931",
            "fax_number": "765-472-1945",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1015 Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Logansport",
            "state": "IN",
            "postal_code": "469471526",
            "country_code": "US",
            "telephone_number": "574-722-5151",
            "fax_number": "574-739-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "DEBORAH",
        "credential": "MSN, APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "309.007493",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71007149A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Choinacky, PHARMD
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• City of Tipton (Tipton Fire Department)
• Michelle Marie Cole
• Mary C Compton, MD
• James Riley Davidson, M.D.
• Daysrx, Inc. (Medicine Shoppe Pharmacy)
• Mary Delph
• Destry W Lambert MD Inc
• Diabetes and Endocrinology Associates LLC

• Psychiatric/Mental Health Nurse Practitioner in Tipton, IN
• Providers in Tipton, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.