Active NPI
Robert Arlen Davison, D. C.
- Chiropractor
- Berkeley, CA
National Provider Identifier
1609012475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 19096
- Practice address
- 2500 Martin Luther King Jr Way
Berkeley, CA 94704-2613 - Phone
- (510) 843-2584
- NPI assigned
- Dec 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 19096 | CA | Primary |
Addresses
Primary practice location
2500 Martin Luther King Jr Way
Berkeley, CA 94704-2613
Mailing address
324 Lexington Ave
San Leandro, CA 94577-1629
Phone (925) 683-1847
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120813000647 | CA | Practitioner - Chiropractic | 1456507169 | Practice locations: Berkeley, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 1987
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2500 Martin Luther King Jr Way
Berkeley, CA 94704-2613
Phone (510) 843-2584
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19096 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306800000000",
"number": "1609012475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 LEXINGTON AVE",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945771629",
"telephone_number": "925-683-1847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 MARTIN LUTHER KING JR WAY",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947042613",
"telephone_number": "510-843-2584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVISON",
"first_name": "ROBERT",
"middle_name": "ARLEN",
"name_prefix": "Dr.",
"credential": "D. C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-30",
"last_updated": "2011-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "19096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkeley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.