Michael James Davidson, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO781 Issued in TN

Practice address

1090 N Ellington Pkwy
Suite 102
Lewisburg, TN 37091-2227

Phone

(913) 359-0019

Fax

(931) 359-7381

NPI assigned

Mar 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Maury Regional Hospital

  • Clinic/Center
  • Hohenwald, TN
  • NPI 1023038122
  NPD

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352851200000",
    "number": "1740240902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 W JAMES CAMPBELL BLVD",
            "address_2": "SUITE 303",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384014659",
            "telephone_number": "931-359-0019",
            "fax_number": "931-359-7381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 N ELLINGTON PKWY",
            "address_2": "SUITE 102",
            "city": "LEWISBURG",
            "state": "TN",
            "postal_code": "370912227",
            "telephone_number": "913-359-0019",
            "fax_number": "931-359-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2012-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "DO781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NUMBER",
            "identifier": "3130078",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3710089",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3302360",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cook'S Family Dentistry
• William Benjamin Copeland, LADAC II
• County of Marshall Board of Education
• Emily Hill Darnell
• David Alfredson MD PC
• Teresa Dianne Davis, NP
• Thomas Davis, BS
• Ryan Dehm
• Dentistry of Lewisburg
• Dialysis Associates, LLC

• Family Medicine Physician in Lewisburg, TN
• Providers in Lewisburg, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.