Individual provider Active NPI

Andria Davidson

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1891023537
Registry record updated Nov 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
561278-1 Issued in NY
Practice address
9312 Farragut Rd
Brooklyn, NY 11236-2026
Phone
(347) 789-1689
NPI assigned
Nov 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 561278-1 NY Primary

Addresses

Primary practice location

9312 Farragut Rd
Brooklyn, NY 11236-2026

Mailing address

9312 Farragut Rd
Brooklyn, NY 11236-2026
Phone (347) 789-1689

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

State licenses

LicenseStateTypeSpecialty
561278-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258502400000",
    "number": "1891023537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9312 FARRAGUT RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112362026",
            "telephone_number": "347-789-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9312 FARRAGUT RD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112362026",
            "telephone_number": "347-789-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "ANDRIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-18",
        "last_updated": "2009-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "561278-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.