Individual provider Active NPI

Jeannette Carol Davison, APNC

  • Internal Medicine Physician
  • Ringwood, NJ
National Provider Identifier
1437348976
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
NN74066 Issued in NJ
Practice address
52 Skyline Dr
Ringwood, NJ 07456-2020
Phone
(973) 962-6200
NPI assigned
Oct 22, 2007
Last updated
Oct 22, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NN74066 NJ Primary

Addresses

Primary practice location

52 Skyline Dr
Ringwood, NJ 07456-2020

Mailing address

52 Skyline Dr
Ringwood, NJ 07456-2020
Phone (973) 962-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100322000128 NJ Practitioner - Nurse Practitioner 8325173974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

340 C Ramapo Valley Rd
Oakland, NJ 07436-2711
Phone (201) 416-4346

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NN74066NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group Internal Medicine CurrentSince Jun 15, 2014 Accepting new patients
Borough of Ringwood PastSince Dec 1, 2015 Accepting new patients
NP Associates PA Past Accepting new patients

Locations

100 Madison Ave
Morristown, NJ 07960
Phone (973) 538-5210

465 South St
Ste 200
Morristown, NJ 07960
Phone (973) 971-7130

340C Ramapo Valley Rd
Oakland, NJ 07436
Phone (201) 416-4346

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1437348976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 SKYLINE DR",
            "city": "RINGWOOD",
            "state": "NJ",
            "postal_code": "074562020",
            "telephone_number": "973-962-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 SKYLINE DR",
            "city": "RINGWOOD",
            "state": "NJ",
            "postal_code": "074562020",
            "telephone_number": "973-962-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "JEANNETTE",
        "middle_name": "CAROL",
        "credential": "APNC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-22",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "NN74066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ringwood, NJ

Sources for this page

Verify at the official NPI Registry.