Davison Pediatrics PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301063221 Issued in MI

Legal business name

DAVISON PEDIATRICS PC

Practice address

1260 N Irish Rd
Ste a
Davison, MI 48423-2276

Phone

(810) 658-9550

Fax

(810) 658-2202

NPI assigned

Mar 30, 2011

Last updated

Mar 30, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kamal Hasan, MDNPI 1427150168

Title

Owner

Phone

(810) 658-9550

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kamal S Hasan, MD

  • Pediatrics Physician
  • Davison, MI
  • NPI 1427150168
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1609165646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 N IRISH RD",
            "address_2": "STE A",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484232276",
            "telephone_number": "810-658-9550",
            "fax_number": "810-658-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 N IRISH RD",
            "address_2": "STE A",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484232276",
            "telephone_number": "810-658-9550",
            "fax_number": "810-658-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVISON PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "HASAN",
        "authorized_official_first_name": "KAMAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-658-9550",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301063221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Davis, LMT
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• Davison Family Dentistry (Irish Road Dental)
• Davison Family Dentistry, P.C. (Irish Road Dental)
• Davison Medical Practice PLC
• Davison Pharmacy LLC (Davison Pharmacy)
• Davison Physical Therapy Specialists, LLC
• Davison Urgent Care PC
• Davison Vision Center LLC
• Scott Delange, DPT

• Pediatrics Physician in Davison, MI
• Providers in Davison, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.

Verify at the official NPI Registry.