Grant Garner Davidson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1161876 Issued in NC

Practice address

1 Medical Center Blvd
Winston Salem, NC 27157-0001

Phone

(336) 716-2011

NPI assigned

Jun 9, 2019

Last updated

Jun 9, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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 NC, SC2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• McLeod Regional Medical Center of the Pee Dee, Inc

  dba Cbo MRMC Emergency

  • Emergency Medical Services (Emergency Medicine) Physician
  • Florence, SC
  • NPI 1154371433
  Medicare reassignment NPD
• McLeod Regional Medical Center of the Pee Dee, Inc

  dba McLeod Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Florence, SC
  • NPI 1871775841
  NPD

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

{
    "created_epoch": "1560038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560038400000",
    "number": "1336708882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4766 EAGLE PATH",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271276816",
            "telephone_number": "803-486-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "GRANT",
        "middle_name": "GARNER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-09",
        "last_updated": "2019-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "1161876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David J. Barabe, D.D.S., P.a.
• Jarrod David, DPT
• Lisa Renee David, MD
• Deborah W Davidson, FNP
• Elizabeth Davidson, FNP
• Kelli Leigh Davidson, MS,RD,CSO,LDN
• Claudia Davies, LCSW
• Katie Renee Davin, LCMHCA
• Davis Eye Associates OD, PA
• Katherine Marie Davis Francois, MD, MPH

• Medical Physician Assistant in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.