Active NPI
Jessica M. Davidson, M.D.
- Neonatal-Perinatal Medicine Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- ME454991
- Practice address
- 111 S 11TH St
Philadelphia, PA 19107-4824 - Phone
- (215) 595-5652
- Fax
- (215) 923-9519
- NPI assigned
- Jun 25, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 241647 | MA | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | ME454991 | PA | Primary |
Addresses
Primary practice location
111 S 11TH St
Philadelphia, PA 19107-4824
Mailing address
PO Box 191
Provider Enrollment Department
Rockland, DE 19732-0191
Phone (904) 697-5062
Other names 1
- Jessica Crocker
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jdavidson272711@direct.med.utah.edu | Direct | University of Utah |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 241647 | MA | MD | Pediatrics Physician |
| ME454991 | PA | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| University of Utah Pediatric Acuity Care | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| University of Utah Pediatric Acuity Care | Pediatrics | Current | Accepting new patients |
| Ihc Health Services Inc | Family Medicine | Current | Accepting new patients |
| University of Utah Pediatric Acuity Care | Current | Accepting new patients | |
| University of Utah Pediatric Acuity Care | Neonatal-Perinatal Medicine | Past | Accepting new patients |
| SCHC Pediatric Associates, LLC | Pediatrics | Past | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
2250 N Miller Campus Dr
Lehi, UT 84048
Phone (385) 531-1000
127 S 500 E
Ste 200
Salt Lake City, UT 84102
127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478
5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998
400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109
Organizations & group practices 8
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.
-
- Pediatric Critical Care Medicine Physician
- Salt Lake City, UT
- NPI 1619325131
Pediatrics
-
- Multi-Specialty Clinic/Center
- Provo, UT
- NPI 1477678589
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
- Pediatric Hospice and Palliative Medicine Physician
- Salt Lake City, UT
- NPI 1851898365
-
- Pediatric Critical Care Medicine Physician
- Salt Lake City, UT
- NPI 1891156741
-
- Pediatrics Physician
- Philadelphia, PA
- NPI 1255363578
-
- Neonatal-Perinatal Medicine Physician
- Salt Lake City, UT
- NPI 1770947814
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634601600000",
"number": "1861620064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 191",
"address_2": "PROVIDER ENROLLMENT DEPARTMENT",
"city": "ROCKLAND",
"state": "DE",
"postal_code": "197320191",
"telephone_number": "904-697-5062",
"fax_number": "302-651-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 S 11TH ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191074824",
"telephone_number": "215-595-5652",
"fax_number": "215-923-9519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "JESSICA",
"middle_name": "M.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-25",
"last_updated": "2021-10-19",
"certification_date": "2021-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "241647",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "PA",
"license": "ME454991",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jdavidson272711@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "CROCKER",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.