Thomas John Davidson IV, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

SC006438 Issued in PA

Practice address

1331 Hamilton Ter SE
Roanoke, VA 24014-1805

Phone

(251) 747-4401

NPI assigned

May 21, 2013

Sex

Male

Sole proprietor

Yes

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 NY

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

Podiatry

Education

Other, 2012

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.

• Thomas J Davidson IV Wny LLC

  • Podiatrist
  • Tonawanda, NY
  • NPI 1013697770
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1295171858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 HAMILTON TER SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141805",
            "telephone_number": "251-747-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 HAMILTON TER SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141805",
            "telephone_number": "251-747-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "PA",
            "license": "SC006438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David L Jones DDS PC
• Christine K Davidson, RN, MS, NP-C
• Jesse Thornhill Davidson III, M.D.
• Patricia H Davidson, LCSW
• Tamara Davidson, PHARMD
• Davis and McDaniel Veterans Care Center
• Alexander Davis, L. AC.
• Audrey K Davis, M.S., CCC-SLP
• Beverly A Davis, PA-C
• Brittney Allison Davis, PHARMD

• Primary Podiatric Medicine Podiatrist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Primary Podiatric Medicine Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.