Edward T Davis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD425243 Issued in PA

Practice address

3213 Nazareth Rd
Palmer Township, PA 18045-2000

Phone

(610) 559-2060

Fax

(610) 559-2064

NPI assigned

Apr 17, 2006

Last updated

Mar 21, 2012By the provider in NPPES

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

Practice roles

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.

• Jamestown Primary Care LLP

  • Family Medicine Physician
  • Jamestown, NY
  • NPI 1639104631
  NPD (past)

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1861456725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 OSTRUM ST",
            "address_2": "ENROLLMENT CENTER",
            "city": "BETHLEHEM",
            "state": "PA",
            "postal_code": "180151000",
            "telephone_number": "484-526-6048",
            "fax_number": "484-526-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3213 NAZARETH RD",
            "city": "PALMER TOWNSHIP",
            "state": "PA",
            "postal_code": "180452000",
            "telephone_number": "610-559-2060",
            "fax_number": "610-559-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "EDWARD",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD425243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011851330002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brice Richard Ambron, PA-C
• Jessica Alexis Okomura Bernal, PHARMD
• Dylan Bryce Corriere
• Robert Ealey
• Christopher Martinez Gross, PHARM. D.
• Stefanie Ruth Josten, PH.D.
• Steven L Lewis, MD
• Salliann Schippers, LCSW

• Family Medicine Physician in Palmer Township, PA
• Providers in Palmer Township, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.