Individual provider Active NPI

Brian B Davidson, PT

  • Physical Therapist
  • Lancaster, OH
National Provider Identifier
1720039506
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2506 Issued in OH
Practice address
2405 N Columbus St
Suite 220
Lancaster, OH 43130-8185
Phone
(740) 687-3346
Fax
(740) 689-9736
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2506 OH Primary

Addresses

Primary practice location

2405 N Columbus St
Suite 220
Lancaster, OH 43130-8185

Mailing address

2405 N Columbus St
Suite 220
Lancaster, OH 43130-8185
Phone (740) 687-3346

Other identifiers 1

IdentifierTypeStateIssuer
0449107MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080724000453 OH Practitioner - Physical Therapist in Private Practice 4183531007 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2506OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
River Valley Orthopaedics & Sports Medicine, Inc. CurrentSince Jun 15, 2008 Accepting new patients
Columbus Radiology Corp Past Accepting new patients

Locations

2405 N Columbus St
Ste 120
Lancaster, OH 43130
Phone (740) 687-3346

2656 N Columbus St
Ste D
Lancaster, OH 43130
Phone (740) 687-3346

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213660800000",
    "number": "1720039506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 N COLUMBUS ST",
            "address_2": "SUITE 220",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308185",
            "telephone_number": "740-687-3346",
            "fax_number": "740-689-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 N COLUMBUS ST",
            "address_2": "SUITE 220",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431308185",
            "telephone_number": "740-687-3346",
            "fax_number": "740-689-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "BRIAN",
        "middle_name": "B",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2008-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "2506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0449107",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.