Laura Davidson, MPAS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1861 Issued in MN

Practice address

3365 Plymouth Blvd.
Suite 110
Plymouth, MN 55446

Phone

(612) 486-4200

NPI assigned

Feb 4, 2013

Last updated

Aug 6, 2016By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Reese Surgical Group PLLC

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  • Edina, MN
  • NPI 1972762631
  NPD (past)

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470441600000",
    "number": "1588903009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3365 PLYMOUTH BLVD.",
            "address_2": "SUITE 110",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55446",
            "telephone_number": "612-486-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 PLYMOUTH BLVD.",
            "address_2": "SUITE 110",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55446",
            "telephone_number": "612-486-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "LAURA",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-04",
        "last_updated": "2016-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "1861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodore Mark Danger
• Daniel G. Raether, DDS, Ms, LTD.
• Denis F Darko, M.D.
• Monica Guzdkiewicz Daugherty, APRN, CNM, PMHNP
• Candida Amber Davenport, LAC, LADC
• Eliza Davies, RN
• Elizabeth Davin
• Alan A Davis, LMFT
• Brooke Rochelle Davis, LICSW
• Krista M Davis, OD, FAAO

• Physician Assistant in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2016; 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.