Mindy Jo Davidson, CADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

102 N Hancock St
Ottumwa, IA 52501-4648

Phone

(641) 622-2800

Fax

(641) 682-2826

NPI assigned

Apr 1, 2019

Last updated

Apr 1, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: mdavi@firstresources.us

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.

• First Resources Corp

  • Community/Behavioral Health Agency
  • Ottumwa, IA
  • NPI 1518124411
  NPD (past)
• First Resources Corp

  • Community/Behavioral Health Agency
  • Sigourney, IA
  • NPI 1699838474
  NPD (past)

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1528520525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 N HANCOCK ST",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525014648",
            "telephone_number": "641-622-2800",
            "fax_number": "641-682-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N HANCOCK ST",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525014648",
            "telephone_number": "641-622-2800",
            "fax_number": "641-682-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "MINDY",
        "middle_name": "JO",
        "credential": "CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdavi@firstresources.us",
            "affiliation": "N",
            "endpointDescription": "business e-mail address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "102 N Hancock St",
            "city": "Ottumwa",
            "state": "IA",
            "country_code": "US",
            "postal_code": "525014648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristi Lynn Damerval, PTA
• Darling Children's Dentistry
• Alyssa Darling, DMD
• Brian Darling
• Richard Davenport II, LMHC, LMSW
• Amanda J Davis, ARNP
• Shawn Dawson, M.D.
• Ronda Kim Dennis-Smithart, M.D.,F.A.A.P.
• Jacoby Lynne Deshler, LMSW
• Shelbi Dexter, ARNP

• Addiction (Substance Use Disorder) Counselor in Ottumwa, IA
• Providers in Ottumwa, IA by specialty
• Addiction (Substance Use Disorder) Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.