Active NPI
Jennifer H Davisson, PA-C
- Physician Assistant
- Kansas City, MO
National Provider Identifier
1114024668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1500993
- Practice address
- 1010 Carondelet Drive
Suite 125
Kansas City, MO 64114-2846 - Phone
- (816) 942-1150
- Fax
- (816) 942-0322
- NPI assigned
- Sep 19, 2006
- Last updated
- Jul 13, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1500993 | KS | Primary |
Addresses
Primary practice location
1010 Carondelet Drive
Suite 125
Kansas City, MO 64114-2846
Mailing address
4601 W 109TH St
Suite 116
Overland Park, KS 66211-1313
Phone (913) 469-1115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Saint Louis University School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1010 Carondelet Dr
Kansas City, MO 64114-4846
Phone (816) 942-1150
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
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.
-
- Specialist
- Kansas City, MO
- NPI 1831137462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626134400000",
"number": "1114024668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 W 109TH ST",
"address_2": "SUITE 116",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662111313",
"telephone_number": "913-469-1115",
"fax_number": "913-469-9446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 CARONDELET DRIVE",
"address_2": "SUITE 125",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641142846",
"telephone_number": "816-942-1150",
"fax_number": "816-942-0322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVISSON",
"first_name": "JENNIFER",
"middle_name": "H",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-19",
"last_updated": "2021-07-13",
"certification_date": "2021-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KS",
"license": "1500993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.