Active NPI
Richard Thomas Davies, PA-C
- Physician Assistant
- Williamsport, PA
National Provider Identifier
1316913494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA002015L
- Practice address
- 1100 Grampian Blvd
Williamsport, PA 17701-1909 - Phone
- (570) 320-7525
- Fax
- (570) 320-7484
- NPI assigned
- Feb 27, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA002015L | PA | Primary |
Addresses
Primary practice location
1100 Grampian Blvd
Williamsport, PA 17701-1909
Mailing address
1201 Grampian Blvd
Williamsport, PA 17701-1900
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA002015L | PA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1443484800000",
"number": "1316913494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 GRAMPIAN BLVD",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177011900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 GRAMPIAN BLVD",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177011909",
"telephone_number": "570-320-7525",
"fax_number": "570-320-7484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIES",
"first_name": "RICHARD",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-27",
"last_updated": "2015-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA002015L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamsport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.