Individual provider Active NPI

Jayne M. Davidson, RN.CDE.

  • Diabetes Educator Registered Nurse
  • Flagstaff, AZ
National Provider Identifier
1184109456
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
RN051849 Issued in AZ
Practice address
77 W Forest Ave Ste 202
Flagstaff, AZ 86001-1483
Phone
(927) 213-6439
NPI assigned
Oct 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X RN051849 AZ Primary

Addresses

Primary practice location

77 W Forest Ave Ste 202
Flagstaff, AZ 86001-1483

Mailing address

77 W Forest Ave Ste 202
Flagstaff, AZ 86001-1483
Phone (927) 213-6439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN051849AZMDDiabetes Educator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1184109456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE STE 202",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011483",
            "telephone_number": "927-213-6439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE STE 202",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011483",
            "telephone_number": "927-213-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "JAYNE",
        "middle_name": "M.",
        "credential": "RN.CDE.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "AZ",
            "license": "RN051849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.