NPIMap

Individual provider Active NPI

Davisson Jean Leandre F E Edmond, M.D

  • Family Medicine Physician
  • Oxford, AL
National Provider Identifier
1376739151
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30459 Issued in AL
Practice address
671 Snow St
Oxford, AL 36203-1212
Phone
(256) 770-4750
Fax
(256) 770-4032
NPI assigned
Sep 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30459 AL Primary

Addresses

Primary practice location

671 Snow St
Oxford, AL 36203-1212

Mailing address

671 Snow St
Oxford, AL 36203-1212
Phone (256) 770-4750

Other identifiers 1

IdentifierTypeStateIssuer
168070MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20110104000734 AL Practitioner - Family PracticePractitioner - Emergency Medicine 2466515630 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Universite de Montreal Faculte de Med Dentaire, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

671 Snow St
Oxford, AL 36203-1212
Phone (256) 770-4750

Hospital & facility affiliations

  • Amedisys Home Health of Anniston Home health agency, Anniston, AL, CCN 017305
  • Enhabit Home Health Home health agency, Hoover, AL, CCN 017009
  • Centerwell Home Health Home health agency, Oxford, AL, CCN 017151
  • Northeast Alabama Regional Medical Center Hospital, Anniston, AL, CCN 010078

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anniston Pathology Current Accepting new patients
Southeast Medical Group, P.C. Family Medicine CurrentSince Nov 22, 2023 Accepting new patients
The Health Care Authority of the City of Anniston CurrentSince Apr 25, 2011 Accepting new patients
Paragon Contracting Services LLC CurrentSince Dec 1, 2014 Accepting new patients
The Health Care Authority of the City of Anniston CurrentSince Apr 25, 2011 Accepting new patients
Family Health & Wellness Center L.L.C. Family Medicine CurrentSince Oct 6, 2014 Accepting new patients

Locations

400 E 10th St
Anniston, AL 36207
Phone (256) 235-5121

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

1701 Pelham Rd S
Jacksonville, AL 36265
Phone (256) 435-4970

1612 Hamric Dr E
Ste 100
Oxford, AL 36203
Phone (256) 835-4756

671 Snow St
Oxford, AL 36203
Phone (256) 454-8620

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15682/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations & group practices 6

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

Hospital & facility affiliations 4

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": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1376739151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 SNOW ST",
            "city": "OXFORD",
            "state": "AL",
            "postal_code": "362031212",
            "telephone_number": "256-770-4750",
            "fax_number": "256-770-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "671 SNOW ST",
            "city": "OXFORD",
            "state": "AL",
            "postal_code": "362031212",
            "telephone_number": "256-770-4750",
            "fax_number": "256-770-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMOND",
        "first_name": "DAVISSON",
        "middle_name": "JEAN LEANDRE F E",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-14",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "30459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168070",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, AL

Sources for this page

Verify at the official NPI Registry.