Jeremiah Davidson
Individual provider Active NPI Registered Nurse · Allentown, PA
NPI 1134799653 · NPPES record last updated Jun 28, 2021
Key facts
- NPI
- 1134799653
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- RN646059 (PA)
- Practice address
- 1200 S Cedar Crest Blvd
Allentown, PA 18103-6202 - Phone
- (610) 402-8000
- NPI assigned
- Jun 28, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 11
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Professional Anesthesia Services of North America PC
Lehigh Valley Physician Group
Practice addresses (Care Compare)
1503 N Cedar Crest Blvd
Allentown, PA 18104-2310
Phone (610) 861-8080
2310 Highland Ave
Bethlehem, PA 18020-8920
Phone (610) 861-8080
330 Main St
Dickson City, PA 18519-1691
Phone (610) 402-6164
Hospital & facility affiliations
- Lehigh Valley Hospital
- St Lukes Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210825002136 | PA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 8325443641 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN646059 | PA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lehigh Valley Physician Group | Current |
Accepting new patients | |
| Lehigh Valley Anesthesia Services, P. C. | Current |
Accepting new patients | |
| Professional Anesthesia Services of North America P.C. | Current |
Accepting new patients | |
| Grandview Anesthesia Associates | Current |
Accepting new patients | |
| Lehigh Valley Physician Group | Current |
Accepting new patients | |
| Lehigh Valley Physician Group | Current | Accepting new patients |
Locations
2100 Mack Blvd
Fl 4
Allentown, PA 18103
1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200
2310 Highland Ave
Bethlehem, PA 18020
Phone (610) 691-4300
5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641
330 Main St
Scranton, PA 18519
Phone (570) 330-5000
700 Lawn Ave
Sellersville, PA 18960
Phone (215) 453-4000
100 E Lancaster Ave
Ste 158
Wynnewood, PA 19096
Phone (484) 206-5800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN646059 | PA | Yes |
Addresses
Primary practice location
1200 S Cedar Crest Blvd
Allentown, PA 18103-6202
Mailing address
2630 Elm Hill Pike Ste 350
Nashville, TN 37214-3176
Other providers in Allentown, PA
- David J. Shingles, D.O., P.C.
- David W Whitson M.D. P.C.
- David W. Whitson, M.D. P.C.
- Caitlyn Rose Davidson
- Caroline Davidson
- Viva Davidson
- Kathryn A Davie
- Ashlee Davies
- Christina M Davies
- Sandra Davies
All providers in Allentown, PA · Registered Nurse in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.