Individual provider Active NPI

Richard S Davidson, MD

  • Psychiatry Physician
  • Ogden, UT
National Provider Identifier
1801820774
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
1642288905 Issued in UT
Practice address
237 26TH Street
Ogden, UT 84401-3105
Phone
(801) 625-3605
Fax
(801) 625-3615
NPI assigned
Jul 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
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
Psychiatry Physician 2084P0800X 1642288905 UT Primary

Addresses

Primary practice location

237 26TH Street
Ogden, UT 84401-3105

Mailing address

237 26TH Street
Ogden, UT 84401-3105
Phone (801) 625-3605

Other identifiers 1

IdentifierTypeStateIssuer
876000308007MedicaidUT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20050413001239 UT Practitioner - Psychiatry 6406893163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
George Washington University School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weber Human ServicesGroup PAC ID 3274430244, 42 clinicians

Practice addresses (Care Compare)

237 26TH St
Ogden, UT 84401-3105
Phone (801) 625-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1642288905UTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weber Human Services CurrentSince Apr 13, 2013 Accepting new patients
Weber Human Services CurrentSince Apr 13, 2013 Accepting new patients

Locations

237 26th St
Ogden, UT 84401
Phone (801) 625-3605

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801820774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 26TH STREET",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844013105",
            "telephone_number": "801-625-3605",
            "fax_number": "801-625-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 26TH STREET",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844013105",
            "telephone_number": "801-625-3605",
            "fax_number": "801-625-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "RICHARD",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "1642288905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "876000308007",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

Verify at the official NPI Registry.