JACKSON DAVIS (NPI# 1750918470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750918470 |
Entity Type | Individual |
Full Name | JACKSON DAVIS |
Practice Address |
508 Fulton St Durham NC 27705-3875 |
Mailing Address |
2197 Eagle Trace Ln Woodbury MN 55129-4287 |
Practice Telephone | 9192866874 |
Mailing Telephone | 9497057395 |
Enumeration Date | 2020-03-24 |
Last Update Date | 2020-03-24 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225434848 | Jackson Lee Davis IIi | Preventive Medicine | 4121 Minnesota Ave Ne, Washington, DC 20019-3572 | 2014-11-10 |
Street Address |
508 FULTON ST |
City | DURHAM |
State | NC |
Zip Code | 27705-3875 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043217086 | Stuart Hall Manning | Internal Medicine | 508 Fulton St, C/o Durham Va Medical Center, Durham, NC 27705-3875 | 2005-07-06 |
1245839083 | Jessica Elizabeth Cornett | Recreation Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-22 |
1043819808 | Rebecca Parker Maccioli | Recreation Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-22 |
1174122055 | Aline Xayasouk | Occupational Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-21 |
1730786187 | Kathryn Masincupp | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-07 |
1700490349 | Sarah Elizabeth Parker | Nurse Practitioner | 508 Fulton St, Durham, NC 27705-3875 | 2020-09-01 |
1144833716 | Phillip Charles Tampis | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-24 |
1164033445 | Alexandra Demascole | Social Worker | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-11 |
1386254498 | Krishna Rana | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-04 |
1730799842 | Jinah Han | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-04 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
Find all providers in zip 27705 |
Taxonomy Code | 2251X0800X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Physical Therapist |
Specialization | Orthopedic |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679132690 | Demario Sharrod Lewis | Physical Therapist | 200 W Woodcroft Pkwy Apt 62b, Durham, NC 27713-8086 | 2019-06-12 |
1568979987 | Michael Alan Schmidt | Physical Therapist | Dumc 3965 Duke South Clinic 1b/1c, Durham, NC 27710-0001 | 2018-01-08 |
1568428340 | Spine Rehabilitation and Reeducation Center of North | Physical Therapist | 2309 Sparger Rd, Pob 2403, Durham, NC 27705-2227 | 2006-04-21 |
1831707066 | Kyle Brendan Stapleton | Physical Therapist | 2301 Erwin Rd, Durham, NC 27705-4699 | 2020-07-14 |
1407334550 | Trevor Lentz | Physical Therapist | 2400 Pratt St, Durham, NC 27705-3976 | 2018-07-31 |
1750890802 | Monica Austin | Physical Therapist | 4709 Creekstone Dr Ste 300, Durham, NC 27703-0016 | 2017-09-20 |
1376070029 | Preston Roundy | Physical Therapist | 40 Duke Medicine Cir, Durham, NC 27710-4000 | 2017-05-12 |
1477080190 | Morven Ann Ross Malay | Physical Therapist | 501 Douglas St, Durham, NC 27705-3888 | 2017-05-11 |
1326474420 | Activedge Fitness and Sports Performance, Inc. | Physical Therapist | 4221 Garrett Rd, Suite 1-2, Durham, NC 27707-3467 | 2013-09-20 |
1437399979 | Insideout Body Therapies, LLC | Physical Therapist | 5720 Fayetteville Rd, Suite 101, Durham, NC 27713-9089 | 2009-02-24 |
Find all providers in DURHAM |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.