Individual provider Active NPI

Tina J Davidson, CNP

  • Family Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1093883621
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.06617 Issued in OH
Practice address
2489 Stelzer Rd Ste 101
Columbus, OH 43219-4007
Phone
(614) 473-1300
Fax
(614) 473-0722
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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 APRN.CNP.06617 OH Primary

Addresses

Primary practice location

2489 Stelzer Rd Ste 101
Columbus, OH 43219-4007

Mailing address

2489 Stelzer Rd Ste 101
Columbus, OH 43219-4007
Phone (614) 473-1300

Other identifiers 1

IdentifierTypeStateIssuer
2508978MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20210312001560 OH Practitioner - Nurse Practitioner 1153216221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Incare Health Solutions LLCGroup PAC ID 5092980730, 66 clinicians

Practice addresses (Care Compare)

1100 Sunbury Rd
Suite 706
Delaware, OH 43015-6040
Phone (740) 417-8568

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Incare Health Solutions LLC CurrentSince Jun 20, 2024 Accepting new patients
Incare Health Solutions, LLC Family CurrentSince Jun 20, 2024 Accepting new patients
Central Ohio Primary Care Physicians, Inc. Family CurrentSince Mar 1, 2021 Accepting new patients
Central Ohio Primary Care Physicians Inc Current Accepting new patients
Central Ohio Primary Care Physicians, Inc. CurrentSince Mar 1, 2021 Accepting new patients
Ohio Nurse Practitioners, Inc. Past Accepting new patients

Locations

1085 Polaris Pkwy
Columbus, OH 43240
Phone (614) 505-0021

2489 Stelzer Rd
Ste 101
Columbus, OH 43219
Phone (614) 473-1300

4832 W Broad St
Columbus, OH 43228
Phone (614) 465-7457

4885 Olentangy River Rd
Columbus, OH 43214
Phone (614) 326-5665

1100 Sunbury Rd
Ste 706
Delaware, OH 43015
Phone (740) 363-3133

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

Interoperability endpoints

  • Direct secure messaging: tdavidson19262@copcp.medicity.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1093883621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2489 STELZER RD STE 101",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432194007",
            "telephone_number": "614-473-1300",
            "fax_number": "614-473-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2489 STELZER RD STE 101",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432194007",
            "telephone_number": "614-473-1300",
            "fax_number": "614-473-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "TINA",
        "middle_name": "J",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.06617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2508978",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.