NPIMap

Individual provider Active NPI

Evan M Davidson, MD

  • Family Medicine Physician
  • Louisville, KY
National Provider Identifier
1902245848
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
51086 Issued in KY
Practice address
9880 Angies Way Ste 420
Louisville, KY 40241
Phone
(502) 394-6200
NPI assigned
Jun 24, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R3662 KY
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 51086 KY Primary

Addresses

Primary practice location

9880 Angies Way Ste 420
Louisville, KY 40241

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 272-5395

Other practice location 1

2195 Harrodsburg Rd Ste 125
Lexington, KY 40504-3504
Phone (859) 257-4732

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address edavidson147407@direct.nortonhealthcare.org Direct
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180829003915 KY Practitioner - Family Practice 4880838515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Kentucky College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51086KYMDFamily Medicine Physician
R3662KYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Single Specialty Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Aug 1, 2018 Accepting new patients
Community Medical Associates, Inc. Single Specialty CurrentSince Aug 1, 2018 Accepting new patients

Locations

157 Towne Dr
Ste 104
Elizabethtown, KY 42701
Phone (270) 769-2273

202 Limestone St S
Ste 1C
Frankfort, KY 40601
Phone (502) 665-8377

9880 Angies Way
Ste 420
Louisville, KY 40241
Phone (502) 394-6200

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: edavidson147407@direct.nortonhealthcare.org

Organizations & group practices 3

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.

Hospital & facility affiliations 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1902245848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-272-5395",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9880 ANGIES WAY STE 420",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40241",
            "telephone_number": "502-394-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2195 Harrodsburg Rd Ste 125",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405043504",
            "country_code": "US",
            "telephone_number": "859-257-4732",
            "fax_number": "859-323-6661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "EVAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-24",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "R3662",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "51086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edavidson147407@direct.nortonhealthcare.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9880 Angies Way Ste 420",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "9880 Angies Way Ste 420",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "40241",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.