Kenneth H Davidson, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

103663 Issued in NY

Practice address

1415 Portland Ave
Suite 350
Rochester, NY 14621-3038

Phone

(585) 426-9278

Fax

(585) 338-2738

NPI assigned

Feb 3, 2006

Last updated

Oct 9, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 9

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kenneth H. Davidson, MD, PC

  • Cardiovascular Disease Physician
  • Rochester, NY
  • NPI 1457547184
  Authorized official Same address or phone
• Rochester Cardiopulmonary Group, P.C.

  • Cardiovascular Disease Physician
  • Rochester, NY
  • NPI 1710967534
  NPD (past)

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1871565861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 PORTLAND AVE",
            "address_2": "SUITE 350",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213038",
            "telephone_number": "585-426-9278",
            "fax_number": "585-338-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 PORTLAND AVE",
            "address_2": "SUITE 350",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213038",
            "telephone_number": "585-426-9278",
            "fax_number": "585-338-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "KENNETH",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "103663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "Y019296",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BLUE",
            "identifier": "005002871",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P010103663",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHOICE CARE",
            "identifier": "07341",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "9913",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD WESTERN NY",
            "identifier": "005002871",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00450853",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "10453",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "MD4426",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel David, M.D.
• Tamala Miyako David, RN, FNP
• Tracey Q. Davidoff, MD
• Carla Marie Davidson, M.S. CCC-SLP
• Heather L B Davidson, M.S
• Shaiasia Davidson, LPN
• Caitlin Davie, MHC-LP
• Alexander Thomas Davies, PA
• Shawna Davies, RN
• Mariel Davila-Martinez, M.D.

• Cardiovascular Disease Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Cardiovascular Disease Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; 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.