Individual provider Active NPI

Amy Noble Davidson, PA-C

  • Physician Assistant
  • Washington Court House, OH
National Provider Identifier
1104179183
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1450 Columbus Ave Ste 103
Washington Court House, OH 43160-3701
Phone
(740) 333-2243
Fax
(740) 333-2248
NPI assigned
Oct 16, 2012
Last updated
Jul 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

1450 Columbus Ave Ste 103
Washington Court House, OH 43160-3701

Mailing address

1450 Columbus Ave Ste B 6-7-8
Washington Court House, OH 43160-3701
Phone (740) 333-2236

Other identifiers 1

IdentifierTypeStateIssuer
0077380MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amydavidson@fcmhms.allscriptsdirect.net

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
I20130129000521 OH Practitioner - Physician Assistant 7618121674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adena Medical Group LLCGroup PAC ID 1153456579, 384 clinicians

Practice addresses (Care Compare)

110 Vaugh Lane
Suite 20
Chillicothe, OH 45601
Phone (740) 779-7201

1430 Columbus Ave
Washington Court House, OH 43160-1703
Phone (740) 335-1210

1450 Columbus Ave
Washington Court House, OH 43160-3701

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.93 of 100Reported as group
Quality
64.42
Promoting interoperability
99
Improvement activities
40
Cost
73.2

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: adavidson@yourcarecommunity.org
  • Direct secure messaging: adavidson1066395@direct.osumc.edu

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1104179183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 COLUMBUS AVE STE B 6-7-8",
            "city": "WASHINGTON COURT HOUSE",
            "state": "OH",
            "postal_code": "431603701",
            "telephone_number": "740-333-2236",
            "fax_number": "740-333-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 COLUMBUS AVE STE 103",
            "city": "WASHINGTON COURT HOUSE",
            "state": "OH",
            "postal_code": "431603701",
            "telephone_number": "740-333-2243",
            "fax_number": "740-333-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "AMY",
        "middle_name": "NOBLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-16",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0077380",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amydavidson@fcmhms.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "1450 Columbus Ave Ste 103",
            "city": "Washington Court House",
            "state": "OH",
            "country_code": "US",
            "postal_code": "431603701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Washington Court House, OH

Sources for this page

Verify at the official NPI Registry.