Active NPI
Jeanne Davis, PA
- Physician Assistant
- Syracuse, NY
National Provider Identifier
1720524036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 020356-1
- Practice address
- 750 E Adams St
Syracuse, NY 13210-2306 - Phone
- (315) 464-3119
- NPI assigned
- Jan 10, 2017
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 020356-1 | NY | Primary |
Addresses
Primary practice location
750 E Adams St
Syracuse, NY 13210-2306
Mailing address
326 Salt Springs Rd
Syracuse, NY 13224-1551
Phone (585) 478-0344
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020356-1 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504224000000",
"number": "1720524036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 SALT SPRINGS RD",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132241551",
"telephone_number": "585-478-0344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 E ADAMS ST",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132102306",
"telephone_number": "315-464-3119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "JEANNE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-10",
"last_updated": "2017-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "020356-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.