Jacelyn Paige Davidson, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

63181 Issued in MN

Practice address

2501 Keenan Dr
International Falls, MN 56649-2181

Phone

(218) 283-9431

NPI assigned

May 21, 2015

Last updated

Nov 28, 2018By 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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centracare Health System - MelroseGroup PAC ID 1658270368, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centracare Health System - Melrose Hospital Hospital, Melrose, MN, CCN 241330

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdavidson429239@direct.centracare.com

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.

• Centracare Health System - Melrose

  dba CentraCare Health - Melrose Hospital

  • Critical Access Hospital
  • Melrose, MN
  • NPI 1720045073
  Medicare reassignment Care Compare group NPD
• Centracare Health System - Long Prairie

  • Critical Access Hospital
  • Long Prairie, MN
  • NPI 1164471678
  Medicare reassignment NPD
• Centracare Health System - Sauk Centre

  dba CentraCare Health - Sauk Centre Clinic

  • Rural Health Clinic/Center
  • Sauk Centre, MN
  • NPI 1578813762
  Medicare reassignment NPD
• Centracare Health System - Sauk Centre

  • Critical Access Hospital
  • Sauk Centre, MN
  • NPI 1740553932
  Medicare reassignment NPD
• Centracare Health System - Sauk Centre

  • Medicare Defined Swing Bed Hospital Unit
  • Sauk Centre, MN
  • NPI 1487928743
  NPD

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

• Centracare Health System - Melrose

  dba CentraCare Health - Melrose Hospital

  • Critical Access Hospital
  • Melrose, MN
  • NPI 1720045073
  Care Compare affiliation
• Centracare Health System - Melrose

  dba CentraCare Health - Melrose Clinic

  • Rural Health Clinic/Center
  • Melrose, MN
  • NPI 1730407586

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1689053704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940",
            "telephone_number": "701-364-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 KEENAN DR",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566492181",
            "telephone_number": "218-283-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "JACELYN",
        "middle_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-21",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "63181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Cobban, PA-C
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• Dean Christopher Cowman, DC
• Samantha Ann Crossley
• Bonita Lynn Despain, PTA
• Whitney Lee Donner
• E L Anderson City Drug Store (City Drug)
• Essentia Health Virginia, LLC (Essentia Health International Falls Clinic)
• Essentia Health Virginia, LLC (Essentia Health International Falls Clinic)

• Family Medicine Physician in International Falls, MN
• Providers in International Falls, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.