Individual provider Active NPI

Marc Romayne Davidson, MD

  • Orthopaedic Surgery Physician
  • Gresham, OR
National Provider Identifier
1225017783
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD17775 Issued in OR
Practice address
24076 SE Stark
Ste 110
Gresham, OR 97030
Phone
(503) 661-5388
Fax
(503) 666-3393
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD17775 OR Primary

Addresses

Primary practice location

24076 SE Stark
Ste 110
Gresham, OR 97030

Mailing address

24076 SE Stark
Ste 110
Gresham, OR 97030
Phone (503) 661-5388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20060130000709 OR Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 6406870880 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Orthopedic and Sports Medicine Clinic LLP Orthopaedic Surgery CurrentSince Jun 1, 2001 Accepting new patients
Pearl Foot and Ankle LLC Past Accepting new patients

Locations

24076 SE Stark St
Ste 110
Gresham, OR 97030
Phone (503) 661-5388

9820 NE Cascades Pkwy
Portland, OR 97220
Phone (503) 284-4147

Interoperability endpoints

  • Direct secure messaging: marc.davidson.1@10802.direct.athenahealth.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1225017783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24076 SE STARK",
            "address_2": "STE 110",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "503-661-5388",
            "fax_number": "503-666-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24076 SE STARK",
            "address_2": "STE 110",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97030",
            "telephone_number": "503-661-5388",
            "fax_number": "503-666-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "MARC",
        "middle_name": "ROMAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OR",
            "license": "MD17775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

Verify at the official NPI Registry.