Individual provider Active NPI

Jamila Dayo Davison, M.D.

  • Emergency Medicine Physician
  • Boston, MA
National Provider Identifier
1174606123
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME114790 Issued in FL
Practice address
75 State St FL 26
Boston, MA 02109-1827
Phone
(888) 982-7956
NPI assigned
Oct 23, 2006
Last updated
Jul 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Q5642 TX
Emergency Medicine Physician 207P00000X ME114790 FL Primary

Addresses

Primary practice location

75 State St FL 26
Boston, MA 02109-1827

Mailing address

75 State St FL 26
Boston, MA 02109-1827
Phone (888) 982-7956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX, GA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20130314000245 FL Practitioner - Emergency Medicine 4385722107 Reassigns benefits to 1 organization
I20170816000381 TX Practitioner - Emergency Medicine 4385722107 Reassigns benefits to 1 organization
I20180911001466 GA Practitioner - Emergency Medicine 4385722107 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME114790FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Emergency Partners LLC Emergency Medicine CurrentSince Jun 20, 2017 Accepting new patients
Halifax Healthcare Systems Inc Emergency Medicine CurrentSince Apr 1, 2018 Accepting new patients
Phoebe Putney Memorial Hospital Inc CurrentSince Aug 1, 2018 Accepting new patients
Phoebe Putney Memorial Hospital Inc CurrentSince Aug 1, 2018 Accepting new patients
Ace Care Management Services LLC PastSince Jul 1, 2013 Accepting new patients
Davison Health Solutions LLC PastSince Feb 1, 2013 Accepting new patients

Locations

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

303 N Clyde Morris Blvd
Fl First
Daytona Beach, FL 32114
Phone (386) 425-6198

417 W 3rd Ave
Albany, GA 31701
Phone (229) 317-2207

500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1174606123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 STATE ST FL 26",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021091827",
            "telephone_number": "888-982-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 STATE ST FL 26",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021091827",
            "telephone_number": "888-982-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "JAMILA",
        "middle_name": "DAYO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q5642",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME114790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.