Individual provider Active NPI

Allan Bernard Davidson, MD

  • Pulmonary Disease Physician
  • Colorado Springs, CO
National Provider Identifier
1174528897
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
27534 Issued in CO
Practice address
871 Oxford LN
Colorado Springs, CO 80905-7905
Phone
(719) 635-7300
Fax
(719) 635-7300
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 27534 CO
Sleep Medicine (Internal Medicine) Physician 207RS0012X 27534 CO
Pulmonary Disease Physician 207RP1001X 27534 CO Primary

Addresses

Primary practice location

871 Oxford LN
Colorado Springs, CO 80905-7905

Mailing address

871 Oxford LN
Colorado Springs, CO 80905-7905
Phone (719) 635-7300

Other practice location 1

1650 Cochrane Cir
Ft Carson, CO 80913-4613
Phone (719) 524-3742

Other identifiers 1

IdentifierTypeStateIssuer
01275346MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20100114000431 CO Practitioner - Pulmonary Disease 4587650221 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27534COMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Waves, Inc. CurrentSince Jun 20, 2022 Accepting new patients
Uch-MHS CurrentSince Oct 1, 2012 Accepting new patients
Delta Waves of Woodland Park Inc PastSince Jun 20, 2022 Accepting new patients
Memorial Health System Past Accepting new patients
Uch-MHS Past Accepting new patients

Locations

5835 Lehman Dr
Ste 101
Colorado Springs, CO 80918
Phone (719) 262-9283

8890 N Union Blvd
Colorado Springs, CO 80920
Phone (719) 364-5633

1725 E Boulder St
Ste 204
Colorado Springs, CO 80909
Phone (719) 365-6614

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1174528897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 OXFORD LN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809057905",
            "telephone_number": "719-635-7300",
            "fax_number": "719-635-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 OXFORD LN",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809057905",
            "telephone_number": "719-635-7300",
            "fax_number": "719-635-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Cochrane Cir",
            "address_purpose": "LOCATION",
            "city": "Ft Carson",
            "state": "CO",
            "postal_code": "809134613",
            "country_code": "US",
            "telephone_number": "719-524-3742",
            "fax_number": "719-524-1465",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "ALLAN",
        "middle_name": "BERNARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CO",
            "license": "27534",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "CO",
            "license": "27534",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CO",
            "license": "27534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01275346",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.