Robert Lantz Davidson, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

M7907 Issued in ID

Practice address

3525 E Louise Dr Ste 195
Meridian, ID 83642

Phone

(208) 846-8335

Fax

(208) 846-8336

NPI assigned

May 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  NPD
• St Lukes Clinic-Treasure Valley LLC

  dba St Lukes RHC - Trinity Mountain

  • Family Medicine Physician
  • Mountain Home, ID
  • NPI 1417297821
  NPD
• Overlake Internal Medicine Associates Inc PS

  • Internal Medicine Physician
  • Bellevue, WA
  • NPI 1407896806
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526428800000",
    "number": "1144275694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 E LOUISE DR STE 195",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426303",
            "telephone_number": "208-846-8335",
            "fax_number": "208-846-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 E LOUISE DR STE 195",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-846-8335",
            "fax_number": "208-846-8336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4620 Enterprise Way Ste 101",
            "address_purpose": "LOCATION",
            "city": "Caldwell",
            "state": "ID",
            "postal_code": "836056764",
            "country_code": "US",
            "telephone_number": "208-846-8335",
            "fax_number": "208-846-8336",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1109 W Myrtle St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837026971",
            "country_code": "US",
            "telephone_number": "208-846-8335",
            "fax_number": "208-846-8336",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4424 E Flamingo Ave Ste 195",
            "address_purpose": "LOCATION",
            "city": "Nampa",
            "state": "ID",
            "postal_code": "836879289",
            "country_code": "US",
            "telephone_number": "208-846-8335",
            "fax_number": "208-846-8336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "ROBERT",
        "middle_name": "LANTZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2018-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "ID",
            "license": "M7907",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "ID",
            "license": "M7907",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003661400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David J Butuk MD PA (Meridian Family Medicine)
• Elaine M. Davidson, M.D.
• Emily Jean Davidson, PMHNP
• Hannah Davidson
• Janet Maureen Davidson, DPT
• Cody Justin Davies, NP
• Heidi Davies, CSA
• Lindsey Janae Davies, COTA
• Amanda Colby Davis
• Emily Davis

• Nephrology Physician in Meridian, ID
• Providers in Meridian, ID by specialty
• Nephrology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; 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.