JOHN HOWARD DAVIDSON (NPI# 1043480056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043480056 |
| Entity Type | Individual |
| Full Name | JOHN HOWARD DAVIDSON |
| Credential | PA |
| Practice Address |
405 W Jackson St Carbondale IL 62901-1462 |
| Mailing Address |
16091 Swingley Ridge Rd Suite #100 Chesterfield MO 63017-2056 |
| Practice Telephone | 6185490721 |
| Practice Fax Number | 6184570469 |
| Mailing Telephone | 6367282200 |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2019-10-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363A00000X | Physician Assistant | 085001572 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | ILLINOIS LICENSE | 085001572 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 16091 Swingley Ridge Rd, Suite #100, Chesterfield, MO 630172056 | 6367282200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164989539 | John Davidson | Pharmacist | 2688 Highway 411 Se, Fairmount, GA 30139-2924 | 2019-02-21 |
| 1255588349 | John Robert Davidson | Dentist | 27 N Park Ave, Peru, IN 46970-1718 | 2008-08-20 |
| 1306000831 | John Barry Davidson Jr. | General Practice | 158 Mill Point Dr, Hampton, VA 23669-3535 | 2008-07-14 |
| 1689733651 | John James Davidson | Chiropractor | 2103 C Laurel Bush Road, Bel Air, MD 21015 | 2006-12-06 |
| 1346282258 | John Allan Davidson | Social Worker | 9 Kattelville Rd, Binghamton, NY 13901-5859 | 2006-06-12 |
| 1689069874 | John Albert Davidson IIi | Podiatrist | 345 F St Ste 100, Chula Vista, CA 91910-2632 | 2015-04-03 |
| 1205142395 | John Robert Davidson | Counselor | 1790 W 11th Ave Ste A, Eugene, OR 97402-3780 | 2010-08-26 |
| 1851616155 | John Carl Davidson Jr. | Physical Therapist | 3347 Masonic Dr, Alexandria, LA 71301-3842 | 2010-03-30 |
| 1992987416 | John Edward Davidson | Counselor | 1592 Granville Pike, Lancaster, OH 43130-1076 | 2007-11-27 |
| 1235337833 | John M Davidson | Nurse Anesthetist, Certified Registered | 262 Danny Thomas Pl, Memphis, TN 38105-3678 | 2007-07-05 |
| Street Address |
405 W JACKSON ST |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194726851 | Shahriar Bozorgzadeh | Emergency Medicine | 405 W Jackson St, Carbondale, IL 62901-1462 | 2005-08-03 |
| 1568071132 | Cynthia Sue Davis | Nurse Practitioner | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-07-29 |
| 1629686019 | Dianne Zuasula Catolos | Physical Therapist | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-07-21 |
| 1871113696 | Summer R Black | Nurse Anesthetist, Certified Registered | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-04-22 |
| 1871123067 | Hailee Elizabeth Bowlin | Nurse Practitioner | 405 W Jackson St, Carbondale, IL 62901-1462 | 2020-01-16 |
| 1972061737 | Briana Nichole Jones | Speech-Language Pathologist | 405 W Jackson St, Carbondale, IL 62901-1462 | 2019-03-11 |
| 1700362183 | John Grady Johnston Jr. | Registered Nurse | 405 W Jackson St, Carbondale, IL 62901 | 2018-07-18 |
| 1972099067 | Andrew Mcnally | Nurse Anesthetist, Certified Registered | 405 W Jackson St, Carbondale, IL 62901-1462 | 2018-07-02 |
| 1134610587 | Megan E Sims | Nurse Anesthetist, Certified Registered | 405 W Jackson St, Carbondale, IL 62901-1462 | 2018-05-22 |
| 1447749833 | Erika Diericx | Pharmacist | 405 W Jackson St, Carbondale, IL 62901-1462 | 2018-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821618471 | Derrik Abell | Physician Assistant | 11648 Rolling Meadows Ln, Carbondale, IL 62901-0750 | 2020-04-23 |
| 1598277907 | Mallory Lindberg | Physician Assistant | 207 W Jackson St Ste 201, Carbondale, IL 62901-1408 | 2017-10-26 |
| 1790009488 | Northeast Physician Housecalls, Inc. | Physician Assistant | 52 Dundaff St, Carbondale, PA 18407-1879 | 2010-03-24 |
| 1164618633 | Rachel Marie Sargent | Physician Assistant | 600 N. Giant City Rd, Carbondale, IL 62902-6413 | 2007-09-19 |
| 1851502421 | Kelly K Hand | Physician Assistant | 665 E Lake Rd, Carbondale, IL 62901-5347 | 2007-05-25 |
| 1073729877 | Kathleen Ann Dodd | Physician Assistant | 374 East Grand, Carbondale, IL 62901-6740 | 2007-05-16 |
| 1376680462 | Gabriel A Martin | Physician Assistant | 103 S Washington St, Suite 202, Carbondale, IL 62901-3030 | 2007-01-30 |
| 1649385873 | Mary L Brandenburg | Physician Assistant | 1301 E Walnut St, Carbondale, IL 62901-5004 | 2006-08-20 |
| 1841237120 | Patricia A Boudet | Physician Assistant | 404 S Lewis Ln, Carbondale, IL 62901-3547 | 2006-06-02 |
| 1871542811 | Michael Anthony Bryant | Physician Assistant | 305 W Jackson St Ste 103, Carbondale, IL 62901-1474 | 2006-05-08 |
| Find all providers in CARBONDALE | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
Please comment or provide details below to improve the information on JOHN HOWARD DAVIDSON.
| 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.