Active NPI
Carolyn E Davidson, PH.D.
- Clinical Psychologist
- Louisville, KY
National Provider Identifier
1316032634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1729
- Practice address
- 800 Zorn Ave
Louisville, KY 40206-1433 - Phone
- (615) 618-7295
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1729 | TN | Primary |
Addresses
Primary practice location
800 Zorn Ave
Louisville, KY 40206-1433
Mailing address
2308 Arroyo Dr
Chattanooga, TN 37421-2823
Phone (423) 432-8959
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0172012 | Other | TN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2023 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1729 | TN | MD | Clinical Psychologist |
| 1826 | GA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613520000000",
"number": "1316032634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2308 ARROYO DR",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374212823",
"telephone_number": "423-432-8959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 ZORN AVE",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402061433",
"telephone_number": "615-618-7295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "CAROLYN",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2021-02-17",
"certification_date": "2021-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TN",
"license": "1729",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0172012",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.