Individual provider Active NPI

Jonathan Victor Davidow, MD

  • Neurology Physician
  • Charlottesville, VA
National Provider Identifier
1184366569
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
0116037541 Issued in VA
Practice address
1215 Lee St
Charlottesville, VA 22908-3522
Phone
(434) 924-5306
Fax
(434) 982-1064
NPI assigned
Apr 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0116037541 VA
Neurology Physician 2084N0400X 0116037541 VA Primary

Addresses

Primary practice location

1215 Lee St
Charlottesville, VA 22908-3522

Mailing address

1215 Lee St Box 800394
Charlottesville, VA 22908-0816
Phone (434) 924-5306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20220929001176 WI Order and Referring Only - General SurgeryPractitioner - General Surgery 4688050545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0116037541VAMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: jonathan.davidow.1@20955.direct.athenahealth.com
  • Direct secure messaging: jdavidow572056@direct.healthsystem.virginia.edu

NPI Registry JSON

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1184366569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST BOX 800394",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-5306",
            "fax_number": "434-982-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229083522",
            "telephone_number": "434-924-5306",
            "fax_number": "434-982-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDOW",
        "first_name": "JONATHAN",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-07",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116037541",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0116037541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.