Active NPI
Michele R Davidson, PMHNP
- Psychiatry Physician
- Chesapeake, VA
National Provider Identifier
1487782538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 0024146903
- Practice address
- 1545 Crossways Blvd Ste 250
Chesapeake, VA 23320-0218 - Phone
- (757) 992-9600
- Fax
- (757) 432-3211
- NPI assigned
- Mar 1, 2007
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 0024146903 | VA | Primary |
Addresses
Primary practice location
1545 Crossways Blvd Ste 250
Chesapeake, VA 23320-0218
Mailing address
1545 Crossways Blvd Ste 250
Chesapeake, VA 23320-0218
Phone (757) 992-9600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Jun 20, 2020 through Jun 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0024146903 | VA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615420800000",
"number": "1487782538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1545 CROSSWAYS BLVD STE 250",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233200218",
"telephone_number": "757-992-9600",
"fax_number": "757-432-3211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1545 CROSSWAYS BLVD STE 250",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233200218",
"telephone_number": "757-992-9600",
"fax_number": "757-432-3211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "MICHELE",
"middle_name": "R",
"credential": "PMHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-01",
"last_updated": "2021-03-11",
"certification_date": "2021-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "VA",
"license": "0024146903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.