Individual provider Active NPI

Carol Lynn Davidson, APN

  • Family Nurse Practitioner
  • Olney, TX
National Provider Identifier
1093748998
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
559769 Issued in TX
Practice address
306 W Main St
Box 308
Olney, TX 76374-1851
Phone
(940) 564-3546
Fax
(940) 564-8882
NPI assigned
Jul 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 559769 TX Primary

Addresses

Primary practice location

306 W Main St
Box 308
Olney, TX 76374-1851

Mailing address

RR 3 Box 158
Olney, TX 76374-9788
Phone (940) 873-4691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20050727000578 TX Practitioner - Nurse Practitioner 5092743567 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
559769TXMDFamily Nurse Practitioner
509769TXMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Olney-Hamilton Hospital District CurrentSince Apr 11, 2017 Accepting new patients
Olney Hamilton Hospital District CurrentSince Oct 1, 2020 Accepting new patients
Olney-Hamilton Hospital District CurrentSince Apr 11, 2017 Accepting new patients
Hendrick Provider Network Past Accepting new patients

Locations

100 S Avenue M
Olney, TX 76374
Phone (940) 564-3546

101 S Ave M
Olney, TX 76374
Phone (940) 564-3546

306 W Main St
Olney, TX 76374
Phone (940) 564-3546

306 W Main St
#308
Olney, TX 76374
Phone (940) 564-3546

901 W Hamilton St
Olney, TX 76374
Phone (940) 564-3546

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093748998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 3 BOX 158",
            "city": "OLNEY",
            "state": "TX",
            "postal_code": "763749788",
            "telephone_number": "940-873-4691",
            "fax_number": "940-873-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 W MAIN ST",
            "address_2": "BOX 308",
            "city": "OLNEY",
            "state": "TX",
            "postal_code": "763741851",
            "telephone_number": "940-564-3546",
            "fax_number": "940-564-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "CAROL",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "559769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, TX

Sources for this page

Verify at the official NPI Registry.