Mary Ann Davidson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71002633A Issued in IN

Practice address

390 N Courtenay Pkwy
Merritt Island, FL 32953-3456

Phone

(321) 633-3162

Fax

(321) 684-7872

NPI assigned

May 5, 2008

Last updated

Jun 4, 2019By 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, FL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Pensacola Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Pensacola, FL
  • NPI 1801841473
  Medicare reassignment NPD
• Pensacola Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Gulf Breeze, FL
  • NPI 1427356393
  NPD

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1114193786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7045 W ILLIANA DR",
            "city": "WEST TERRE HAUTE",
            "state": "IN",
            "postal_code": "478859006",
            "telephone_number": "812-240-5108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533456",
            "telephone_number": "321-633-3162",
            "fax_number": "321-684-7872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-05",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "9448019",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002633A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anny Daneshvar
• Parvin Deidri Daneshvar, DNP, APRN, FNP-C
• Long Hoang Dang, MD, PHD
• Daniel Cowling
• Cori Megan Daniels, NP
• Cheryl Day
• Malgorzata I Daye, BEHAVIOR ASSISTANT
• Cathy Ann De Bengson, A.P.
• Nadine Rose De Freitas, PT, DPT, ATC
• Jennifer L Deforge, ARNP

• Family Nurse Practitioner in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.