NPIMap

Individual provider Active NPI

Naomi Michelle Davidson, D.O.

  • Nuclear Radiology Physician
  • Renton, WA
National Provider Identifier
1700270832
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Radiology PhysicianTaxonomy code 2085N0904X
License
OP61030552 Issued in WA
Practice address
400 S 43Rd St
Renton, WA 98055-5714
Phone
(253) 661-1700
NPI assigned
Mar 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C7-0005868 DE
Diagnostic Radiology Physician 2085R0202X 031.0119594 VT
Nuclear Radiology Physician 2085N0904X OP61030552 WA Primary

Addresses

Primary practice location

400 S 43Rd St
Renton, WA 98055-5714

Mailing address

PO Box 26730
Federal Way, WA 98093-3730

Other names 1

  • Naomi Michelle Guy Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200625002284 WA Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 8628380847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1819 203Rd Ave SE
Sammamish, WA 98075-9681
Phone (253) 661-1700

2027 Dexter Ave N
Seattle, WA 98109-2721
Phone (253) 661-1700

400 S 43Rd St
Valley Medical Center
Renton, WA 98055-5714
Phone (425) 656-5550

5510 NE 23Rd St
Renton, WA 98059-5289
Phone (253) 661-1700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C7-0005868DEMDInternal Medicine Physician
031.0119594VTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vantage Radiology & Diagnostic Services, a Professional Services Corp Diagnostic Radiology CurrentSince Aug 3, 2020 Accepting new patients
Imaging Partners at Valley LLC Diagnostic Radiology Past Accepting new patients

Locations

533 S 336th St
Ste C
Federal Way, WA 98003
Phone (253) 661-4755

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1700270832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26730",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980933730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "253-661-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "NAOMI",
        "middle_name": "MICHELLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-26",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DE",
            "license": "C7-0005868",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VT",
            "license": "031.0119594",
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "WA",
            "license": "OP61030552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NAOMI",
            "last_name": "GUY",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.