NPIMap

Organization Active NPI

Michael J. Davidson, O.D., P.C.

  • Durable Medical Equipment & Medical Supplies
  • Springfield, VA
National Provider Identifier
1710138391
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0618000035 Issued in VA
Legal business name
MICHAEL J. DAVIDSON, O.D., P.C.
Practice address
8350 Traford LN
FL 2
Springfield, VA 22152-1664
Phone
(703) 569-6363
Fax
(703) 569-3536
NPI assigned
Oct 1, 2008
Last updated
Oct 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

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

Authorized official

Name
Michael Davidson, O.D.NPI 1316901499
Title
President/Owner
Phone
(703) 569-6363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0618000035 VA Primary

Addresses

Primary practice location

8350 Traford LN
FL 2
Springfield, VA 22152-1664

Mailing address

8350 Traford LN
FL 2
Springfield, VA 22152-1664
Phone (703) 569-6363

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930073094 VA DME Supplier - Physician - OptometristDME Supplier - Optician 4688607096 Practice locations: Springfield, VA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Michael J Davidson., O.D., P.C.8350 Traford LN, Springfield, VA 22152-1664(703) 569-6363 Prosthetic Lenses: Conventional Eyeglasses Accepts assignmentParticipating since Jan 1, 1999

National Provider Directory

National Provider Directory
Tax ID family
Michael J Davidson OD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8350 Traford Ln
Ste 2
Springfield, VA 22152
Phone (703) 569-6363

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222819200000",
    "number": "1710138391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8350 TRAFORD LN",
            "address_2": "FL 2",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521664",
            "telephone_number": "703-569-6363",
            "fax_number": "703-569-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8350 TRAFORD LN",
            "address_2": "FL 2",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221521664",
            "telephone_number": "703-569-6363",
            "fax_number": "703-569-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. DAVIDSON, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-01",
        "last_updated": "2008-10-01",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "703-569-6363",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": "0618000035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.