Individual provider Active NPI

Jeremy Scott Davidson, PAC

  • Physician Assistant
  • Asheville, NC
National Provider Identifier
1508963539
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
001000033 Issued in NC
Practice address
1119 Hendersonville Rd
Asheville, NC 28803-7776
Phone
(828) 274-6003
Fax
(828) 274-6004
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001000033 NC Primary

Addresses

Primary practice location

1119 Hendersonville Rd
Asheville, NC 28803-7776

Mailing address

1119 Hendersonville Rd
Asheville, NC 28803-7776
Phone (828) 274-6003

Other identifiers 1

IdentifierTypeStateIssuer
P00771670OtherMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20050629000950 NC Practitioner - Physician Assistant 7113913971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forest Dermatology PAGroup PAC ID 6709806946, 8 clinicians

Practice addresses (Care Compare)

1119 Hendersonville Rd
Suite 200
Asheville, NC 28803-6622
Phone 8282746003313

Hospital & facility affiliations

  • Pardee Hospital Henderson County Hospital, Hendersonville, NC, CCN 340017

Merit-based Incentive Payment System (MIPS)

Final score
90.39 of 100Reported as apm
Quality
77.7
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: jdavidson@forestdermatology.emadirect.md

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1508963539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 HENDERSONVILLE RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288037776",
            "telephone_number": "828-274-6003",
            "fax_number": "828-274-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 HENDERSONVILLE RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288037776",
            "telephone_number": "828-274-6003",
            "fax_number": "828-274-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "JEREMY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001000033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00771670",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.