Individual provider Active NPI

Martha Davidowicz, FNP-C

  • Family Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1720138704
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN082184 Issued in AZ
Practice address
651 W Coolidge St
Phoenix, AZ 85013-2718
Phone
(602) 248-0550
Fax
(602) 248-0557
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN082184 AZ Primary

Addresses

Primary practice location

651 W Coolidge St
Phoenix, AZ 85013-2718

Mailing address

3423 S Terrace Rd
Tempe, AZ 85282-5538
Phone (480) 820-1269

Other identifiers 1

IdentifierTypeStateIssuer
327313OtherAZAHCCCS PROVIDER NUMBER

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
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720138704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3423 S TERRACE RD",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825538",
            "telephone_number": "480-820-1269",
            "fax_number": "602-248-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 W COOLIDGE ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850132718",
            "telephone_number": "602-248-0550",
            "fax_number": "602-248-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDOWICZ",
        "first_name": "MARTHA",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN082184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS PROVIDER NUMBER",
            "identifier": "327313",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.