Individual provider Active NPI

Steven P Davidson, MD

  • Otolaryngology Physician
  • Traverse City, MI
National Provider Identifier
1942880661
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301512043 Issued in MI
Practice address
1104 Cass St
Traverse City, MI 49684-3236
Phone
(231) 941-1155
Fax
(231) 259-1005
NPI assigned
Apr 8, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 4301512043 MI Primary

Addresses

Primary practice location

1104 Cass St
Traverse City, MI 49684-3236

Mailing address

1104 Cass St
Traverse City, MI 49684-3236
Phone (231) 941-1155

Other practice location 1

4201 St Antoine
5E Uhc
Detroit, MI 48201-2153
Phone (269) 718-8619

Other practice location 2

4100 Park Forest Dr
Traverse City, MI 49684-7331
Phone (231) 392-8900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260616003780 MI Practitioner - Otolaryngology 1456823897

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Wayne State University School of Medicine, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1104 Cass St
Traverse City, MI 49684-3236

1105 6TH St
Traverse City, MI 49684-2386

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: steven.davidson.1@19711.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1942880661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 CASS ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843236",
            "telephone_number": "231-941-1155",
            "fax_number": "231-259-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 CASS ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843236",
            "telephone_number": "231-941-1155",
            "fax_number": "231-259-1005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 St Antoine",
            "address_2": "5E UHC",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012153",
            "country_code": "US",
            "telephone_number": "269-718-8619",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4100 Park Forest Dr",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496847331",
            "country_code": "US",
            "telephone_number": "231-392-8900",
            "fax_number": "231-392-8973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "STEVEN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-08",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301512043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.