Diane Meg Davidson, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

025536 Issued in CT

Practice address

491 Gold Star Hwy
Suite 310
Groton, CT 06340

Phone

(860) 445-8020

Fax

(860) 445-1665

NPI assigned

Jan 30, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Kenneth R Beer MD PA

  • Specialist
  • West Palm Beach, FL
  • NPI 1811183999
  Medicare reassignment NPD
• Eastern Connecticut Dermatology PC

  • Specialist
  • Groton, CT
  • NPI 1760604961
  Authorized official Same address or phone

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1215908991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "491 GOLD STAR HWY",
            "address_2": "SUITE 310",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340",
            "telephone_number": "860-445-8020",
            "fax_number": "860-445-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 GOLD STAR HWY",
            "address_2": "SUITE 310",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340",
            "telephone_number": "860-445-8020",
            "fax_number": "860-445-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "DIANE",
        "middle_name": "MEG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CT",
            "license": "025536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Buenaventura Custodio, INDEPENDENT DUTY HM
• Jennifer Dahlgren, R.D.
• Cynthia Daigneault, LCSW, LADC, EMT
• John Christopher Daniel, MD
• James Michael Davenport, AUD
• Peter Arnold Davis, PA-C
• Steven De Castro
• Arthur Fred Dean, DMD
• Jeremiah Jordan Decasteele
• Lisa Degraff, LMFT

• Dermatology Physician in Groton, CT
• Providers in Groton, CT by specialty
• Dermatology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.