Individual provider Active NPI

Nicholas Richard Davidson, NP

  • Family Nurse Practitioner
  • Indianapolis, IN
National Provider Identifier
1972238012
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71012821A Issued in IN
Practice address
8333 Naab Rd Ste 420
Indianapolis, IN 46260-1992
Phone
(317) 338-6666
NPI assigned
Jul 21, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71012821A IN Primary
Nurse Practitioner 363L00000X 71012821A IN

Addresses

Primary practice location

8333 Naab Rd Ste 420
Indianapolis, IN 46260-1992

Mailing address

8333 Naab Rd Ste 420
Indianapolis, IN 46260-1992

Other practice location 1

8333 Naab Rd Ste 400
Indianapolis, IN 46260-1992
Phone (316) 388-6666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220810001831 IN Practitioner - Nurse Practitioner 9931582871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

8333 Naab Rd
Suite 420
Indianapolis, IN 46260-1992
Phone (317) 338-6666

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71012821AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Medical Group Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nicholas.davidson.1@7598.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1972238012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD STE 420",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8333 NAAB RD STE 420",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601992",
            "telephone_number": "317-338-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8333 Naab Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462601992",
            "country_code": "US",
            "telephone_number": "316-388-6666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "NICHOLAS",
        "middle_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012821A",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71012821A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.