Individual provider Active NPI

William James Davison Jr., D.C.

  • Chiropractor
  • Saint Paul, MN
National Provider Identifier
1336252303
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3462 Issued in MN
Practice address
1408 Arcade St
Saint Paul, MN 55106-1823
Phone
(651) 771-2012
Fax
(651) 771-8747
NPI assigned
Aug 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3462 MN Primary

Addresses

Primary practice location

1408 Arcade St
Saint Paul, MN 55106-1823

Mailing address

1408 Arcade St
Saint Paul, MN 55106-1823
Phone (651) 771-2012

Other identifiers 1

IdentifierTypeStateIssuer
7850174-00MedicaidMN

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

State licenses

LicenseStateTypeSpecialty
3462MNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Diagnostic Imaging, LLC Current Accepting new patients
Capitol Chiropractic & Rehab, PC Past Accepting new patients

Locations

1959 Sloan Pl
Ste 230
Saint Paul, MN 55117
Phone (651) 482-9160

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336252303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 ARCADE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551061823",
            "telephone_number": "651-771-2012",
            "fax_number": "651-771-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 ARCADE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551061823",
            "telephone_number": "651-771-2012",
            "fax_number": "651-771-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "WILLIAM",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7850174-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.