NPIMap

Individual provider Active NPI

Jonathan Merlin Davison, M.D.

  • Nuclear Medicine Physician
  • Tacoma, WA
National Provider Identifier
1376500579
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine PhysicianTaxonomy code 207U00000X
License
01055856A Issued in IN
Practice address
Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-1000
Phone
(253) 968-1645
NPI assigned
May 1, 2006
Last updated
Mar 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01055856A IN
Nuclear Medicine Physician 207U00000X 01055856A IN Primary

Addresses

Primary practice location

Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-1000

Mailing address

9040 Jackson Ave Madigan Army Medical Center
Tacoma, WA 98431-0001
Phone (253) 968-1645

Other identifiers 1

IdentifierTypeStateIssuer
01055856AOtherINPHYSICIAN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170316001652 WA Practitioner - Nuclear MedicinePractitioner - Diagnostic Radiology 9537309190 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nuclear MedicineAlso: Diagnostic Radiology
Education
JS Weill Medical College, Cornell University, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Sound Radiologists Inc P SGroup PAC ID 1254229305, 76 clinicians
Radia Inc P SGroup PAC ID 9931012812, 275 clinicians
Radia California Radiology Medical Group IncGroup PAC ID 8921465998, 134 clinicians

Practice addresses (Care Compare)

1201 S Miller St
Wenatchee, WA 98801-3201
Phone (509) 662-2208

3417 Ensign Rd NE
Olympia, WA 98506-5064
Phone (360) 493-4600

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 491-9480

4441 Paradise Ave W
University Place, WA 98466-1023
Phone (425) 563-1500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01055856AINMDNuclear Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radia Imaging Center Holdings LLC Diagnostic Radiology CurrentSince May 25, 2021 Accepting new patients
Swedish Radia Imaging Center at Edmonds LLC Diagnostic Radiology CurrentSince May 25, 2021 Accepting new patients
Radia Imaging Center Holdings LLC Diagnostic Radiology CurrentSince May 25, 2021 Accepting new patients
Wenatchee Valley Hospital CurrentSince Dec 1, 2021 Accepting new patients
Radia California Radiology Medical Group Inc Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients
Central Washington Health Services Association Current Accepting new patients
Central Washington Health Services Association CurrentSince Jun 1, 2022 Accepting new patients
South Sound Radiologists Inc P S Diagnostic Radiology CurrentSince May 25, 2021 Accepting new patients
Evergreen Radia LLC Diagnostic Radiology CurrentSince May 25, 2021 Accepting new patients
Radia Inc P S Diagnostic Radiology CurrentSince May 25, 2021 Accepting new patients
Sheridan Radiology Services of Central Florida Inc Diagnostic Radiology Past Accepting new patients
American Diagnostics Services LLC Past Accepting new patients
Ozark Tri-County Health Care Consortium Past Accepting new patients

Locations

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

19950 Rinaldi St
Ste 101B
Porter Ranch, CA 91326
Phone (818) 496-7517

1450 Medical Center Dr
Rohnert Park, CA 94928
Phone (707) 546-3210

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

26357 McBean Pkwy
Ste 155
Santa Clarita, CA 91355
Phone (661) 288-5940

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

121 Sotoyome St
Santa Rosa, CA 95405
Phone (707) 546-3141

925 Corporate Cntr Pkwy
Ste A
Santa Rosa, CA 95407
Phone (707) 543-2000

6580 Hembree Ln
Ste 270
Windsor, CA 95492
Phone (707) 838-2044

21700 Highway 99
Edmonds, WA 98026
Phone (425) 640-4949

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

11521 NE 128th St
Ste 200
Kirkland, WA 98034
Phone (425) 952-6100

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

19020 33rd Ave W
Ste 210
Lynnwood, WA 98036
Phone 42556315001

1025 153rd St SE
Ste 200
Mill Creek, WA 98012
Phone (425) 338-4000

3417 Ensign Rd NE
Olympia, WA 98506
Phone (360) 493-4600

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

1229 Madison St
Ste 900
Seattle, WA 98104
Phone (206) 292-6233

500 17th Ave
Seattle, WA 98122
Phone (206) 320-2111

550 17th Ave
Ste 630
Seattle, WA 98122
Phone (206) 320-2158

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

4816 NE Thurston Way
Ste A
Vancouver, WA 98662
Phone (360) 254-4914

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1376500579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE MADIGAN ARMY MEDICAL CENTER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311000",
            "telephone_number": "253-968-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "JONATHAN",
        "middle_name": "MERLIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01055856A",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "IN",
            "license": "01055856A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "01055856A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.