Charles Andrew Davidson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY004112 Issued in GA

Practice address

1784 Century Blvd NE Ste a
Atlanta, GA 30345-3313

Phone

(402) 370-6778

NPI assigned

Sep 19, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Charlie Andrew Davidson Professional name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

University of Nebraska College of Medicine, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charles.davidson.1@6806.direct.athenahealth.com

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.

• Emory Medical Care Foundation Inc

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1063452381
  Medicare reassignment NPD
• Emory Medical Care Foundation Inc

  • Psychiatry Physician
  • Atlanta, GA
  • NPI 1073779591
  NPD
• Emory Medical Care Foundation Inc

  • Diagnostic Radiology Physician
  • Atlanta, GA
  • NPI 1225294739
  NPD

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

{
    "created_epoch": "1284854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1306154885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1784 CENTURY BLVD NE STE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453313",
            "telephone_number": "402-370-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1784 CENTURY BLVD NE STE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453313",
            "telephone_number": "402-370-6778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2221 S 17th St",
            "address_2": "Lancaster County Community Mental Health Center",
            "address_purpose": "LOCATION",
            "city": "Lincoln",
            "state": "NE",
            "postal_code": "685023700",
            "country_code": "US",
            "telephone_number": "402-441-7940",
            "fax_number": "402-441-8625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "62 Lenox Pointe NE Ste B",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303247410",
            "country_code": "US",
            "telephone_number": "404-727-8384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "CHARLES",
        "middle_name": "ANDREW",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-19",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY004112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST LICENSE",
            "identifier": "PSY004112",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLIE",
            "last_name": "DAVIDSON",
            "middle_name": "ANDREW",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Anastasia Davidson, PAAA
• Beverly Davidson, LCSW
• Bradley Scott Davidson, M.D.
• Brea Nicole Davidson
• Brielle K Davidson, MD
• Cheryl Faith Davidson, OT
• Debbi-Ann Davidson, RN, PMHNP, DNP
• Donna Marie Davidson, M.ED CCC/SLP
• Emma Rose Davidson
• Jennifer Katherine Davidson, PHARMD

• Clinical Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; 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.