P. Carl Davidson, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

029861 Issued in GA

Practice address

10366 Commerce St
Summerville, GA 30747-1471

Phone

(706) 857-7777

NPI assigned

Feb 24, 2006

Reactivated

Sep 30, 2008

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 GA

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

Specialty

Ophthalmology

Education

Johns Hopkins University School of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• P. Carl Davidson MD PC

  • Ophthalmology Physician
  • Summerville, GA
  • NPI 1932385960
  Medicare reassignment Authorized official
• Harbin Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Rome, GA
  • NPI 1679599088
  NPD (past)
• Rome Eye Care

  • Durable Medical Equipment & Medical Supplies
  • Rome, GA
  • NPI 1477672780
  NPD (past)

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1295701704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1403 CINDERELLA RD",
            "city": "LOOKOUT MOUNTAIN",
            "state": "GA",
            "postal_code": "307502610",
            "telephone_number": "706-936-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10366 COMMERCE ST",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307471471",
            "telephone_number": "706-857-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "P.",
        "middle_name": "CARL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "deactivation_date": "2008-09-17",
        "reactivation_date": "2008-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "029861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Myrick Copeland, COTA/L
• Matthew Thomas Cornforth, M.D.
• Kaylie Crump
• Kelsey Brooke Crump
• Christopher Kyle Daniel, DMD
• Dawn Davis, LPC
• Anna Dotson
• Natalie B Dunagan, FNP-C
• Nakita Dziegielewski, LCSW
• James Thomas Espy, DPT

• Ophthalmology Physician in Summerville, GA
• Providers in Summerville, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.