Charles D Davidson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

N8263 Issued in AR

Practice address

1210 W Main St
Walnut Ridge, AR 72476-1005

Phone

(870) 886-3543

Fax

(870) 886-3252

NPI assigned

Nov 17, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Arkansas College of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lawrence County Family Clinic, PAGroup PAC ID 1557347572, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Five Rivers Medical Center Home Health Home health agency, Pocahontas, AR, CCN 047148
• Lawrence Memorial Hospital Hospital, Walnut Ridge, AR, CCN 041309
• Baptist Memorial Hospital Jonesboro, Inc. Hospital, Jonesboro, AR, CCN 040118

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Lawrence County Family Clinic, PA

  dba Lawence County Family Clinic, P.A .,Rural Health Clinic

  • Rural Health Clinic/Center
  • Walnut Ridge, AR
  • NPI 1740317452

  5% Or Greater Direct Ownership Interest, Corporate Director

  CMS ownership

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.

• Lawrence County Family Clinic, PA

  • Family Medicine Physician
  • Walnut Ridge, AR
  • NPI 1942337282
  Medicare reassignment Care Compare group NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Memorial Hospital-Jonesboro Inc

  dba NEA Baptist Memorial Hospital

  • General Acute Care Hospital
  • Jonesboro, AR
  • NPI 1386699353
  Care Compare affiliation
• Five Rivers Medical Center Inc

  dba Five Rivers Medical Center Home Health

  • Home Health Agency
  • Pocahontas, AR
  • NPI 1831491554
  Care Compare affiliation
• Lawrence Memorial Health Foundation Inc.

  dba Lawrence Memorial Hospital

  • Critical Access Hospital
  • Walnut Ridge, AR
  • NPI 1194724658
  Care Compare affiliation

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457425902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719",
            "city": "WALNUT RIDGE",
            "state": "AR",
            "postal_code": "724760719",
            "telephone_number": "870-886-3543",
            "fax_number": "870-886-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W MAIN ST",
            "city": "WALNUT RIDGE",
            "state": "AR",
            "postal_code": "724761005",
            "telephone_number": "870-886-3543",
            "fax_number": "870-886-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "CHARLES",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "N8263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Complete Healing Chiropractic, PLLC.
• Shannon Swift Cooper, M.D.
• Lauren Elizabeth Crews, APRN
• Lauren Felts Crook, PHARMD
• Tina Cruce
• Kevin M Diamond, M.D.
• Dawn Dickson
• Steve Matthew Ditto
• Diversicare Leasing Corp. (Walnut Ridge Nursing and Rehabilitation Center)
• Karla Ann Dotson, LCSW

• Family Medicine Physician in Walnut Ridge, AR
• Providers in Walnut Ridge, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.