Active NPI
Gary Eugene Davisson
- Pharmacist
- Lima, OH
National Provider Identifier
1356632798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03124592
- Practice address
- 506 W Market St
Lima, OH 45801-4718 - Phone
- (409) 222-7797
- NPI assigned
- Apr 19, 2011
- Last updated
- Apr 19, 2011
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03124592 | OH | Primary |
Addresses
Primary practice location
506 W Market St
Lima, OH 45801-4718
Mailing address
2119 Buttercup Dr
Lima, OH 45807-1492
Phone (419) 339-9097
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03124592 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303171200000",
"number": "1356632798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2119 BUTTERCUP DR",
"city": "LIMA",
"state": "OH",
"postal_code": "458071492",
"telephone_number": "419-339-9097"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 W MARKET ST",
"city": "LIMA",
"state": "OH",
"postal_code": "458014718",
"telephone_number": "409-222-7797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVISSON",
"first_name": "GARY",
"middle_name": "EUGENE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-19",
"last_updated": "2011-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03124592",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lima, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.