JESSICA M. DAVIDSON (NPI# 1861620064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861620064 |
| Entity Type | Individual |
| Full Name | JESSICA M. DAVIDSON |
| Other Name | JESSICA CROCKER |
| Credential | M.D. |
| Practice Address |
111 S 11th St Philadelphia PA 19107-4824 |
| Mailing Address |
Po Box 191 Provider Enrollment Department Rockland DE 19732-0191 |
| Practice Telephone | 2155955652 |
| Practice Fax Number | 2159239519 |
| Mailing Telephone | 9046975062 |
| Mailing Fax Number | 3026514945 |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2015-07-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 241647 | MA | Allopathic & Osteopathic Physicians |
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
ME454991 | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053766980 | Jessica Davidson | Counselor | 14426 S Outer 40 Rd, Town and Country, MO 63017-5711 | 2016-04-28 |
| 1649682006 | Jessica Davidson | Counselor | 125 Belle Forest Cir Ste 206, Nashville, TN 37221-2126 | 2014-05-20 |
| 1174080071 | Jessica M Davidson | Nurse Practitioner | 855 W Maple St Ste 110, Hartville, OH 44632-7601 | 2019-02-27 |
| 1003355751 | Jessica Lynn Davidson | Case Manager/Care Coordinator | 1233 Edgewater St Nw, Salem, OR 97304-4049 | 2017-02-14 |
| 1942664339 | Jessica Davidson | Social Worker | 349 Broadway, Cambridge, MA 02139-1715 | 2016-04-11 |
| 1447689773 | Jessica Elizabeth Davidson | Contractor | 33 Davis Ave, Valhalla, NY 10595-2001 | 2013-11-07 |
| 1386078368 | Jessica J Davidson | Dietitian, Registered | 1515 Park Ave, Columbus, WI 53925-1618 | 2013-08-27 |
| 1679704357 | Jessica Michelle Davidson | Chiropractor | 901 W Ashland Ave, Glenolden, PA 19036-1101 | 2009-07-29 |
| 1912013418 | Jessica Davidson | Internal Medicine | 795 El Camino Real, Palo Alto, CA 94301-2302 | 2006-08-21 |
| Street Address |
111 S 11TH ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-4824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346246642 | Flavius F. Guglielmo | Radiology | 111 S 11th St, Suite 3390, Philadelphia, PA 19107-4824 | 2005-06-22 |
| 1265046569 | Sherman John Torres | Nurse Anesthetist, Certified Registered | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-09-03 |
| 1609489376 | Andrew Michael Mcguire | Registered Nurse | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-08-24 |
| 1326657420 | Daniel Joseph Leehan | Pharmacist | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-07-24 |
| 1013539436 | Kashyap Rajendra Chauhan | Internal Medicine | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-05-07 |
| 1134749385 | Maria Mattioli | Nurse Practitioner | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-04-17 |
| 1598392151 | Amine Sahmoud | Student in an Organized Health Care Education/Training Program | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-03-24 |
| 1346877198 | Abigail M O'connell | Nurse Practitioner | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-03-23 |
| 1396370342 | Alexandra Elder | Student in an Organized Health Care Education/Training Program | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-03-10 |
| 1134754252 | Christopher James Neely | Student in an Organized Health Care Education/Training Program | 111 S 11th St, Philadelphia, PA 19107-4824 | 2020-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568656981 | Mario Zichella Jr. | Pediatrics | 1025 Walnut Street, Suite 700, Philadelphia, PA 19107-3121 | 2007-08-29 |
| 1235333774 | Andrea Freeman Duncan | Pediatrics | 3401 Civic Center Blvd Fl 2, Philadelphia, PA 19104-4319 | 2007-06-11 |
| 1831302603 | Folasade Ibironke Kehinde | Pediatrics | 160 E Erie Ave Dept Of, Philadelphia, PA 19134-1011 | 2007-05-08 |
| 1639204225 | Kirstie R Marcello | Pediatrics | 111 South 11th Street, 7th Floor College Building, Philadelphia, PA 19107 | 2007-02-22 |
| 1134286677 | Yanick Mary Vibert | Pediatrics | 230 North Broad Street, Mailstop 492, 10th Floor South Tower Neonatology Office, Philadelphia, PA 19102 | 2007-01-03 |
| 1164476842 | Karen Fritz | Pediatrics | St. Christopher's Hospital Erie Ave and Front St, Div of Neonatology, Philadelphia, PA 19131 | 2006-05-19 |
| 1043274376 | Daniel Henry Conway | Pediatrics | Front St and Erie Ave, St. Christopher's Hospital for Children, Philadelphia, PA 19134 | 2006-04-13 |
| 1720623200 | Stc Pediatrics LLC | Pediatrics | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2019-11-08 |
| 1639713076 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-10-29 |
| 1750863619 | Temple Faculty Practice Plan, Inc | Pediatrics | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2018-09-06 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
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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.