Jesse Thornhill Davidson III, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101034302 Issued in VA

Practice address

1234 Franklin Rd SW
Roanoke, VA 24016-4606

Phone

(540) 283-6071

Fax

(540) 283-6098

NPI assigned

Jun 16, 2005

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

Doctor of Medicine

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 and National Provider Directory roles.

• Physicians Care of Virginia PC

  • Nephrology Physician
  • Roanoke, VA
  • NPI 1770688145
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1801891791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164606",
            "telephone_number": "540-345-1561",
            "fax_number": "540-345-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164606",
            "telephone_number": "540-283-6071",
            "fax_number": "540-283-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "JESSE",
        "middle_name": "THORNHILL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101034302",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007311141",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arman Darbani
• John Daugherty, M.D.
• Roxanne Davenport, M.D.
• David L Jones DDS PC
• Christine K Davidson, RN, MS, NP-C
• Patricia H Davidson, LCSW
• Tamara Davidson, PHARMD
• Thomas John Davidson IV, DPM
• Davis and McDaniel Veterans Care Center
• Alexander Davis, L. AC.

• Specialist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.