MR. LARRY V DAVISON (NPI# 1104034446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104034446 |
| Entity Type | Individual |
| Full Name | MR. LARRY V DAVISON |
| Credential | R. PH. |
| Practice Address |
1600 N 2nd St Clinton MO 64735-1192 |
| Mailing Address |
800 W Jefferson St Clinton MO 64735-1939 |
| Practice Telephone | 6608855511 |
| Mailing Telephone | 6608855511 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 09115 | KS | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 28369 | MO | Pharmacy Service Providers |
| Street Address |
1600 N 2ND ST |
| City | CLINTON |
| State | MO |
| Zip Code | 64735-1192 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003801747 | Karl J. Haake | Anesthesiology | 1600 N 2nd St, Clinton, MO 64735-1192 | 2005-09-19 |
| 1770110520 | Aaron Andrew Tjomsland | Physician Assistant | 1600 N 2nd St, Clinton, MO 64735-1192 | 2020-03-23 |
| 1023663770 | Nicole Rebecca Romine | Nurse Practitioner | 1600 N 2nd St, Clinton, MO 64735-1192 | 2019-08-08 |
| 1083172415 | Daniel E Roberson | Registered Nurse | 1600 N 2nd St, Clinton, MO 64735-1297 | 2019-03-05 |
| 1093284549 | Town Square Emergency Associates Pllc | Emergency Medicine | 1600 N 2nd St, Clinton, MO 64735-1192 | 2018-11-14 |
| 1235610395 | Anisa Ranay Burdick | Nurse Practitioner | 1600 N 2nd St, Clinton, MO 64735-1297 | 2018-08-27 |
| 1215414255 | Daniel F. Campbell | Nurse Anesthetist, Certified Registered | 1600 N 2nd St, Clinton, MO 64735-1192 | 2018-07-23 |
| 1992294458 | Aimee Oerke | Dietitian, Registered | 1600 N 2nd St, Clinton, MO 64735-1192 | 2018-05-09 |
| 1285174268 | Mary Darling | Social Worker | 1600 N 2nd St, Clinton, MO 64735-1192 | 2017-02-24 |
| 1891242715 | Michelle Shoemaker | Registered Nurse | 1600 N 2nd St, Clinton, MO 64735-1192 | 2016-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730543778 | Courtney Briggs | Speech-Language Pathologist | 502 S. 5th, Clinton, MO 64735 | 2016-04-06 |
| 1447669924 | James Taylor Thatcher II | Counselor | 1800 Community Drive, Clinton, MO 64735 | 2014-08-08 |
| 1205271897 | Rocksheng Zhong | Psychiatry & Neurology | 1800 Community Dr, Clinton, MO 64735 | 2013-05-08 |
| 1407196272 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1501 E Ohio St, Clinton, MO 64735 | 2013-02-15 |
| 1265614176 | Kristal Lynn Moran | Registered Nurse | 1600 N Second St, Clinton, MO 64735 | 2007-12-03 |
| 1174653406 | Gary Allen Groff | Dentist | 1100 E Ohio St, Clinton, MO 64735 | 2007-03-06 |
| 1306908512 | Andrea Jolynn Bruck | Dentist | 906 E Ohio, Clinton, MO 64735 | 2006-12-14 |
| 1992873889 | Golden Valley Memorial Hospital Home Services | Home Health | 1600 North Second Street, Clinton, MO 64735 | 2006-12-01 |
| 1033205521 | Bradley Mark Townsend | Family Medicine | 1413 South Second Street, Clinton, MO 64735 | 2006-10-04 |
| 1871688473 | Michael Jay Harrison | Chiropractor | 704 E. Ohio, Clinton, MO 64735 | 2006-10-03 |
| Find all providers in zip 64735 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841582 | Autumn Brooke Trifone | Pharmacist | 1795 In 163, Clinton, IN 47842 | 2020-11-04 |
| 1447857909 | Marinda Renee Bryan | Pharmacist | 2526 Hwy 65 S. Ste 101, Clinton, AR 72031 | 2020-10-07 |
| 1811455629 | Deva Sandroni | Pharmacist | 132 Fairmont St Ste B, Clinton, MS 39056-4721 | 2019-03-11 |
| 1225514458 | April Walker | Pharmacist | 100 N. 30th, Clinton, OK 73601 | 2018-07-11 |
| 1659857845 | Sally Drinnon | Pharmacist | 200 S 30th St, Clinton, OK 73601-3657 | 2018-07-11 |
| 1730673237 | Raisa Vladimir Reznik | Pharmacist | 6300 Coventry Way, Clinton, MD 20735-2256 | 2018-06-18 |
| 1962929331 | Jonathan Glen Hubanks | Pharmacist | 202 Clinton Blvd, Clinton, MS 39056-5126 | 2017-08-27 |
| 1871022830 | Mary Venetta Rothermal | Pharmacist | 140 W Michigan Ave, Clinton, MI 49236-9577 | 2017-06-05 |
| 1689028896 | Bridget Piko | Pharmacist | 165 Clinton Lake Rd, Clinton, PA 15026-1927 | 2016-04-14 |
| 1023487055 | Tyler Dougherty | Pharmacist | 1130 N Charles G Seivers Blvd, Clinton, TN 37716-3937 | 2015-09-21 |
| Find all providers in CLINTON | ||||
Please comment or provide details below to improve the information on MR. LARRY V DAVISON.
| 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.