Charles Jordan Davidson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2203DT Issued in KY

Practice address

1824 N Main St
Hazard, KY 41701-1020

Phone

(606) 217-0920

Fax

(606) 217-0922

NPI assigned

Oct 22, 2020

Sex

Male

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 KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Davidson-Moore Eyecare

  • Optometrist
  • Hazard, KY
  • NPI 1306573936
  Medicare reassignment NPD Authorized official
• Dawn C Stratton OD PSC

  • Optometrist
  • Lexington, KY
  • NPI 1649522541
  Medicare reassignment NPD

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1245839000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 WOODLAND AVE",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417012060",
            "telephone_number": "606-217-0920",
            "fax_number": "859-275-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 N MAIN ST",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417011020",
            "telephone_number": "606-217-0920",
            "fax_number": "606-217-0922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 Wellington Way Ste 160",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405031387",
            "country_code": "US",
            "telephone_number": "859-245-2020",
            "fax_number": "859-275-2130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "CHARLES",
        "middle_name": "JORDAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-22",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2203DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Damron-Bell, PSY ASSOCIATE
• Genevia Daniels
• Ruth Darland
• Davidson-Moore Eyecare
• Allie Brooks Davidson, APRN
• Johnathan O'Neil Davidson, PA-C
• Mary Ann Davidson
• Kayla Stidham Davis, M.S.,R.D.,L.D.
• Alyssa Paige Day, DMD
• Brittany Day

• Optometrist in Hazard, KY
• Providers in Hazard, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.