Active NPI
Michael W Davidson, PH.D.
- Psychologist
- Cordova, TN
National Provider Identifier
1790927705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- P0000002093
- Practice address
- 154 Timber Creek Dr Ste 4
Cordova, TN 38018-4252 - Phone
- (901) 268-6963
- NPI assigned
- Apr 6, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | P0000002093 | TN | Primary |
Addresses
Primary practice location
154 Timber Creek Dr Ste 4
Cordova, TN 38018-4252
Mailing address
PO Box 381377
Germantown, TN 38183-1377
Phone (901) 268-6963
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P0000002093 | TN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238976000000",
"number": "1790927705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 381377",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381831377",
"telephone_number": "901-268-6963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "154 TIMBER CREEK DR STE 4",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380184252",
"telephone_number": "901-268-6963"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "MICHAEL",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-06",
"last_updated": "2009-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "TN",
"license": "P0000002093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.