Individual provider Active NPI

Gerard M Davidson, DO

  • Family Medicine Physician
  • Dyer, IN
National Provider Identifier
1689666240
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02000745A Issued in IN
Practice address
840 Richard Rd Ste 2
Dyer, IN 46311-1994
Phone
(219) 322-1450
Fax
(219) 322-8260
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02000745A IN Primary

Addresses

Primary practice location

840 Richard Rd Ste 2
Dyer, IN 46311-1994

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other identifiers 2

IdentifierTypeStateIssuer
0090000854OtherILBCBS GROUP NUMBER
100200710MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gdavidson4709@Direct.FranciscanAlliance.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20050608000538 IN Practitioner - Family Practice 7618910878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Chicago College of Osteopathy, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

840 Richard Rd
Suite 2
Dyer, IN 46311-1994
Phone (219) 322-1450

Hospital & facility affiliations

  • Franciscan Home Care Home health agency, Hobart, IN, CCN 157145
  • Franciscan Health Dyer Hospital, Dyer, IN, CCN 150090
  • Franciscan Health Munster Hospital, Munster, IN, CCN 150165
  • Franciscan Health Crown Point Hospital, Crown Point, IN, CCN 150126
  • Community Hospital Hospital, Munster, IN, CCN 150125
  • Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network Family Medicine Current Accepting new patients
Franciscan Physician Network CurrentSince Aug 1, 2011 Accepting new patients
Franciscan Physician Network CurrentSince Aug 1, 2011 Accepting new patients
St Margaret Mercy Healthcare Centers, Inc. Past Accepting new patients
St Margaret Mercy Healthcare Centers, Inc. Family Medicine Past Accepting new patients
St Margaret Mercy Healthcare Centers, Inc. Family Medicine Past Accepting new patients
St Margaret Mercy Healthcare Centers Family Medicine Past Accepting new patients
St Margaret Mercy Healthcare Centers Family Medicine Past Accepting new patients
St Margaret Mercy Healthcare Centers Inc Family Medicine Past Accepting new patients
St Margaret Mercy Healthcare Centers Family Medicine Past Accepting new patients
St Margaret Mercy Healthcare Centers, Inc. Family Medicine Past Accepting new patients
St Margaret Mercy Healthcare Centers, Inc. Family Medicine Past Accepting new patients
St Margaret Mercy Healthcare Centers, Inc. Family Medicine Past Accepting new patients
Anthony M Grimaldi, DO PC Past Accepting new patients
St Margaret Mercy Healthcare Centers Inc Family Medicine Past Accepting new patients
St Margaret Mercy Healthcare Centers, Inc. Past Accepting new patients
St Margaret Mercy Healthcare Centers, Inc. Past Accepting new patients

Locations

35682 Eagle Way
Chicago, IL 60678

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

840 Richard Rd
Dyer, IN 46311
Phone (219) 322-1450

840 Richard Rd
Ste 3
Dyer, IN 46311
Phone (219) 322-1450

840 Richard Rd
Ste 2
Dyer, IN 46311
Phone (219) 322-1450

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

5454 Hohman Ave
Hammond, IN 46320
Phone (219) 933-2077

10860 Maple Ln
Saint John, IN 46373
Phone (219) 365-7000

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • Direct secure messaging: gdavidson4709@direct.franciscanalliance.org

Organizations & group practices 17

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 17

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1689666240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 RICHARD RD STE 2",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111994",
            "telephone_number": "219-322-1450",
            "fax_number": "219-322-8260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "GERARD",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02000745A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "0090000854",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100200710",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gdavidson4709@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "840 Richard Rd Ste 2",
            "city": "Dyer",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463111994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

Verify at the official NPI Registry.