Active NPI
Wendy Sue Davis, MD
- Pediatrics Physician
- Burlington, VT
National Provider Identifier
1699726729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 042-0007566
- Practice address
- 108 Cherry St
Burlington, VT 05401 - Phone
- (802) 863-7347
- Fax
- (802) 863-7229
- NPI assigned
- May 13, 2006
- Last updated
- Jan 26, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 042-0007566 | VT | Primary |
Addresses
Primary practice location
108 Cherry St
Burlington, VT 05401
Mailing address
108 Cherry St
P O Box 70
Burlington, VT 05402-0070
Phone (802) 863-7347
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0009079 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0007566 | VT | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296000000000",
"number": "1699726729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 CHERRY ST",
"address_2": "P O BOX 70",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054020070",
"telephone_number": "802-863-7347",
"fax_number": "802-863-7229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 CHERRY ST",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "05401",
"telephone_number": "802-863-7347",
"fax_number": "802-863-7229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "WENDY",
"middle_name": "SUE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-13",
"last_updated": "2011-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "VT",
"license": "042-0007566",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0009079",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.