Michelle Goldman Davis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA0307 Issued in TN

Practice address

2550 Business Park Dr NE
Cleveland, TN 37311-6503

Phone

(423) 339-8881

Fax

(423) 464-6126

NPI assigned

Aug 2, 2006

Last updated

May 17, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1386651214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 BUSINESS PARK DR NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373116503",
            "telephone_number": "423-339-8881",
            "fax_number": "423-464-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 BUSINESS PARK DR NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373116503",
            "telephone_number": "423-339-8881",
            "fax_number": "423-464-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MICHELLE",
        "middle_name": "GOLDMAN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "363A00000X",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "PA0307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSITANT NUMBER",
            "identifier": "PA0307",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Brooke Davis
• Aundrea Davis, COTA/L
• Breonna Davis
• Ethan Lane Davis
• Jordan Lian Davis, PHARMD
• Tammy Lynn Davis, BCBA, LBA
• Lakita Dawston
• Dearmond and Jones DDS PC
• Eben A Dearmond Jr.
• Amanda Kelley Deaton

• Medical Physician Assistant in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Medical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.