Marie Davidson, MS, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL4021 Issued in FL

Practice address

3100 Edgewater Dr
Orlando, FL 32804-3722

Phone

(863) 370-3011

NPI assigned

Dec 4, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Marie Kirby Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1417462136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 EDGEWATER DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328043722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 EDGEWATER DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328043722",
            "telephone_number": "863-370-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "MARIE",
        "credential": "MS, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL4021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "KIRBY",
            "credential": "MS, ATC, LAT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Denise Ann Davidson, M.A.
• Faith Davidson
• Jeffery Davidson, MS
• John William Davidson, LMT
• Kristen Davidson, PSY.D.
• Jeffry Daviero
• Megan Davies
• Mary L Daviglus, M.D.,P.A.
• Lourdes Marie Davila Cruz
• Alexandra Davila Garcia, MSCW

• Athletic Trainer in Orlando, FL
• Providers in Orlando, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.