Individual provider Active NPI

Angela Marie Davidson, FNP

  • Family Nurse Practitioner
  • South Euclid, OH
National Provider Identifier
1891330049
Registry record updated Nov 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.025587 Issued in OH
Practice address
3842 Freemont Rd
South Euclid, OH 44121-1938
Phone
(216) 773-3868
NPI assigned
Nov 12, 2019
Last updated
Nov 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.025587 OH Primary

Addresses

Primary practice location

3842 Freemont Rd
South Euclid, OH 44121-1938

Mailing address

3842 Freemont Rd
South Euclid, OH 44121-1938
Phone (216) 773-3868

Other names 1

  • Angela Marie Dykes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200318001771 OH Practitioner - Nurse Practitioner 7517395916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Metrohealth SystemGroup PAC ID 8628982949, 1,150 clinicians
Alok Bhaiji, MD, Inc.Group PAC ID 5193625820, 5 clinicians

Practice addresses (Care Compare)

11100 Saint Clair Ave
Cleveland, OH 44108-1943

7055 Engle Rd
BLDG 5
Middleburg HTS, OH 44130-8491
Phone (440) 816-2556

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alok Bhaiji, MD, Inc. CurrentSince Aug 19, 2020 Accepting new patients
The Metrohealth System CurrentSince Mar 1, 2021 Accepting new patients
The Metrohealth System Current Accepting new patients
The Metrohealth System CurrentSince Mar 1, 2021 Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

7055 Engle Rd
Bldg 5
Cleveland, OH 44130

7055 Engle Rd
Ste 503
Middleburg Heights, OH 44130
Phone (440) 816-2556

Interoperability endpoints

  • Direct secure messaging: adavidson205873@direct.metrohealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573516800000",
    "number": "1891330049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3842 FREEMONT RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441211938",
            "telephone_number": "216-773-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3842 FREEMONT RD",
            "city": "SOUTH EUCLID",
            "state": "OH",
            "postal_code": "441211938",
            "telephone_number": "216-773-3868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-12",
        "last_updated": "2019-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.025587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "DYKES",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Euclid, OH

Sources for this page

Verify at the official NPI Registry.