MRS. JOANNA KELLEY DAVIDSON (NPI# 1154690543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154690543 |
| Entity Type | Individual |
| Full Name | MRS. JOANNA KELLEY DAVIDSON |
| Credential | M.S., R.D., L.D. |
| Practice Address |
777 Hospital Way Building A, Suite 201 Pocatello ID 83201-5175 |
| Mailing Address |
777 Hospital Way Building A, Suite 201 Pocatello ID 83201 |
| Practice Telephone | 2082392737 |
| Practice Fax Number | 2082393778 |
| Mailing Telephone | 2082392737 |
| Mailing Fax Number | 2082393778 |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2011-12-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133V00000X | Dietitian, Registered | D-333 | ID | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174837140 | Joanna Wieczorek Davidson | Emergency Medicine | 1900 W Polk St, 10th Floor, Chicago, IL 60612-3723 | 2010-08-02 |
| Street Address |
777 HOSPITAL WAY BUILDING A, SUITE 201 |
| City | POCATELLO |
| State | ID |
| Zip Code | 83201-5175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104825892 | Gregory S Harrison | Neurological Surgery | 777 Hospital Way, Suite 115, Pocatello, ID 83201-5175 | 2005-07-15 |
| 1801401344 | Sunny Blue Alene Nelson | Physician Assistant | 777 Hospital Way, Pocatello, ID 83201-5175 | 2020-09-11 |
| 1316570757 | Mark Alan Pendleton | Nurse Anesthetist, Certified Registered | 777 Hospital Way, Pocatello, ID 83201-5175 | 2020-02-13 |
| 1508413220 | Hilary Worthen | Specialist/Technologist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-08-19 |
| 1437612447 | Walter S Medlin Md PC | Surgery | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-04-08 |
| 1396203428 | Amber Frost | Family Medicine | 777 Hospital Way, Pocatello, ID 83201-5175 | 2019-03-07 |
| 1649756404 | Kamilla Gundersen | Nurse Practitioner | 777 Hospital Way, Pocatello, ID 83207 | 2018-07-16 |
| 1043716285 | Brice Anderson | Specialist/Technologist | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-04-05 |
| 1851808133 | Rocky Mountain Physician Group LLC | Emergency Medicine | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-01-08 |
| 1154838886 | Mark Willis | Nurse Practitioner | 777 Hospital Way, Pocatello, ID 83201-5175 | 2018-01-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235765330 | Timothy Palmer | Social Worker | 400 S 11th Ave, Ste 204, Pocatello, ID 83201 | 2020-03-20 |
| 1225687759 | Hanna Percy | Nurse Practitioner | 1151 Hospital Way Ste 201, Pocatello, ID 83201 | 2019-09-07 |
| 1659935195 | Carol Jane Dillon | Counselor | 707 North 7th Avenue, Suite D, Pocatello, ID 83201 | 2019-04-30 |
| 1154801595 | Mv Pocatello Ent, LLC | Otolaryngology | 333 N 18th Ave Ste B3, Pocatello, ID 83201 | 2018-08-15 |
| 1306344346 | Ruth Anne Patton | Social Worker | 850 E Young St, Pocatello, ID 83201 | 2018-01-24 |
| 1598289274 | Lucas Alexander Bryan | Specialist/Technologist | 1535 E Terry St, Pocatello, ID 83201 | 2017-08-03 |
| 1205365632 | Geno Alan Giovanini | Denturist | 115 S. 15th Ave. Ste. D, Pocatello, ID 83201 | 2017-06-08 |
| 1518415942 | Kelli Fries-geslin | Nurse Practitioner | 500 South 11 Ave Suite 400, Pocatello, ID 83201 | 2016-09-14 |
| 1346797842 | Shailyn Jenkins | Specialist/Technologist | 665 Warren Ave., Pocatello, ID 83201 | 2016-09-01 |
| 1992258149 | Christopher Jared White | Social Worker | 300 N 7th Ave, Pocatello, ID 83201 | 2016-07-24 |
| Find all providers in zip 83201 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467093682 | Stephanie Lynn Fisher | Dietitian, Registered | 1066 Yellowstone Ave Apt 61, Pocatello, ID 83201-4430 | 2019-09-30 |
| 1952812067 | Natalie Chase Christensen | Dietitian, Registered | 444 Hospital Way Ste 701, Pocatello, ID 83201-2744 | 2017-10-16 |
| 1457738478 | Rachel Ewing | Dietitian, Registered | 533 N Hayes Ave, Pocatello, ID 83204-3023 | 2015-04-28 |
| 1710391669 | Tracy Jo Green | Dietitian, Registered | 705 Ebony St, Pocatello, ID 83201-5643 | 2014-06-19 |
| 1033544580 | Abby Jan Wilson | Dietitian, Registered | 957 Hospital Way Bldg D, Pocatello, ID 83201-5096 | 2013-09-03 |
| 1043598832 | Tiffany Topliff | Dietitian, Registered | 1684 Glacier St, Pocatello, ID 83201-2209 | 2011-07-27 |
| 1699705087 | Karen Diane Donaldson | Dietitian, Registered | 845 W Center St # 208, Pocatello, ID 83204-4205 | 2006-07-03 |
| 1396221073 | Alyssa Marie Hines | Dietitian, Registered | 921 S 8th Ave Stop 8311, Pocatello, ID 83209-8375 | 2018-07-16 |
| 1144738048 | Jessica Badaracco Griffel | Dietitian, Registered | 990 Cesar Chavez Ave, Pocatello, ID 83209-0001 | 2018-01-14 |
| 1922431345 | Misty A Roberts | Dietitian, Registered | 2302 E Terry St, Pocatello, ID 83201-2733 | 2013-08-21 |
| Find all providers in POCATELLO | ||||
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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.