Active NPI
Abigail Davis
- Physician Assistant
- Scranton, PA
National Provider Identifier
1396818746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA052453
- Practice address
- 1800 Mulberry St
Scranton, PA 18510-2369 - Phone
- (570) 969-8128
- NPI assigned
- Nov 15, 2006
- Last updated
- Aug 5, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA052453 | PA | Primary |
Addresses
Primary practice location
1800 Mulberry St
Scranton, PA 18510-2369
Mailing address
PO Box 319
Dunmore, PA 18512-0319
Phone (570) 558-2630
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA052453 | PA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438732800000",
"number": "1396818746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 319",
"city": "DUNMORE",
"state": "PA",
"postal_code": "185120319",
"telephone_number": "570-558-2630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 MULBERRY ST",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185102369",
"telephone_number": "570-969-8128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "ABIGAIL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2015-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PA",
"license": "MA052453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.