Individual provider Active NPI

Jamie M Davidson

  • Peer Specialist
  • Des Moines, IA
National Provider Identifier
1821982034
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
3120 SW 9TH St
Des Moines, IA 50315-2205
Phone
(515) 499-2105
NPI assigned
Jun 4, 2025
Last updated
Jun 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X IA Primary

Addresses

Primary practice location

3120 SW 9TH St
Des Moines, IA 50315-2205

Mailing address

1825 SW White Birch Cir Unit 6
Ankeny, IA 50023-7206
Phone (515) 393-1096

Other identifiers 1

IdentifierTypeStateIssuer
CART-24-401-080OtherIACCAR RECOVERY COACH ACADEMY

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kingdom Living Iowa Peer Specialist CurrentSince Jun 8, 2025 Accepting new patients

Locations

3120 SW 9th St
Des Moines, IA 50315
Phone (515) 499-2105

Organizations & group practices 1

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": "1748995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1821982034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 SW WHITE BIRCH CIR UNIT 6",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500237206",
            "telephone_number": "515-393-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 SW 9TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503152205",
            "telephone_number": "515-499-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "JAMIE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCAR RECOVERY COACH ACADEMY",
            "identifier": "CART-24-401-080",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.