Active NPI
Jordan Davis, MS/LAT/ATC
- Athletic Trainer
- Bismarck, ND
National Provider Identifier
1265088371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 523-14
- Practice address
- 225 N 7TH St
Bismarck, ND 58501-4417 - Phone
- (701) 226-8094
- NPI assigned
- Aug 14, 2019
- Last updated
- Aug 14, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 523-14 | ND | Primary |
Addresses
Primary practice location
225 N 7TH St
Bismarck, ND 58501-4417
Mailing address
2201 Sherman Dr
Bismarck, ND 58504-3105
Phone (701) 226-8094
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 523-14 | ND | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565740800000",
"number": "1265088371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 SHERMAN DR",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585043105",
"telephone_number": "701-226-8094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 N 7TH ST",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585014417",
"telephone_number": "701-226-8094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JORDAN",
"credential": "MS/LAT/ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-14",
"last_updated": "2019-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ND",
"license": "523-14",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bismarck, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.