NPIMap

Individual provider Active NPI

Jason Wesley Davidson, D.C.

  • Chiropractor
  • Waukesha, WI
National Provider Identifier
1821238700
Registry record updated Apr 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4466-012 Issued in WI
Practice address
21075 Swenson Dr
Suite 700
Waukesha, WI 53186-2000
Phone
(612) 802-0865
NPI assigned
Mar 4, 2009
Last updated
Apr 6, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4466-012 WI Primary

Addresses

Primary practice location

21075 Swenson Dr
Suite 700
Waukesha, WI 53186-2000

Mailing address

200 Meadow Oak TRL
Waunakee, WI 53597-1467
Phone (612) 802-0865

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chiro One Wellness Center of Waukesha, LLC Chiropractor PastSince Dec 12, 2015 Accepting new patients

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": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238976000000",
    "number": "1821238700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEADOW OAK TRL",
            "city": "WAUNAKEE",
            "state": "WI",
            "postal_code": "535971467",
            "telephone_number": "612-802-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21075 SWENSON DR",
            "address_2": "SUITE 700",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531862000",
            "telephone_number": "612-802-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "JASON",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-04",
        "last_updated": "2009-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4466-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

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.

Verify at the official NPI Registry.