Individual provider Active NPI

Donna Sanderson Davidson, FNP

  • Family Nurse Practitioner
  • Mount Pleasant, SC
National Provider Identifier
1194488403
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
25755 Issued in SC
Practice address
2114 Highway 41 Ste 105
Mount Pleasant, SC 29466-6204
Phone
(843) 388-9000
Fax
(843) 388-6937
NPI assigned
Oct 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-078074 AL
Family Nurse Practitioner 363LF0000X 25755 SC Primary

Addresses

Primary practice location

2114 Highway 41 Ste 105
Mount Pleasant, SC 29466-6204

Mailing address

2114 Highway 41 Ste 105
Mount Pleasant, SC 29466-6204
Phone (843) 388-9000

Other practice location 1

1241 Woodland Ave
Mount Pleasant, SC 29464-3288
Phone (843) 388-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-078074ALMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1194488403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 HIGHWAY 41 STE 105",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294666204",
            "telephone_number": "843-388-9000",
            "fax_number": "843-388-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 HIGHWAY 41 STE 105",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294666204",
            "telephone_number": "843-388-9000",
            "fax_number": "843-388-6937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1241 Woodland Ave",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294643288",
            "country_code": "US",
            "telephone_number": "843-388-9000",
            "fax_number": "843-388-6937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "DONNA",
        "middle_name": "SANDERSON",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-078074",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "25755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.