Richard W Davidson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110-000021 Issued in VA

Practice address

911 E Main St
Floyd, VA 24091-4183

Phone

(540) 745-2031

NPI assigned

Nov 17, 2005

Last updated

Nov 9, 2008By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carilion Healthcare Corporation

  dba Bridgewater College Student Health Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1447206370
  NPD (past)

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226188800000",
    "number": "1780666503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 OLD QUAKER RD",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243335520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 E MAIN ST",
            "city": "FLOYD",
            "state": "VA",
            "postal_code": "240914183",
            "telephone_number": "540-745-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "RICHARD",
        "middle_name": "W",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2008-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-000021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010083923",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Collins Chiropractic Clinic
• Garry Madison Collins, D.C.
• Commonwealth of Virginia State Board of Health (Floyd County Health Department)
• Joseph Howard Conduff Jr., D.D.S.
• Justin Neal Conduff
• Tara Daystar, B.A. CPM, IBCLC
• Decoding Relationships
• Demoray Clinic
• Bruce David Deutsch, D.C., F.I.A.M.A.
• Dr. Blake Mitnick, Optometrist, PLC

• Physician Assistant in Floyd, VA
• Providers in Floyd, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2008; 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.