JOHN HOWARD DAVIDSON PA
NPI 1043480056
Physician Assistant in Carbondale, IL
About John Howard Davidson Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHN HOWARD DAVIDSON PA (NPI 1043480056) is an individual physician assistant in Carbondale, Illinois, licensed in Illinois (085001572) and active in the NPI registry since March 2008. He is enrolled in Medicare PECOS and maintains 3 additional practice locations.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 3
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
John Howard Davidson Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 62901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CARBONDALE, IL 62901
CARBONDALE, IL 62901
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is John Davidson's NPI number?
The NPI number for John Davidson is 1043480056. It was assigned to this individual provider in the NPPES registry on March 5, 2008.
Where is John Davidson located?
John Davidson practices at 405 W Jackson St, Carbondale, IL 62901. The listed phone number is (618) 549-0721.
What is John Davidson's specialty?
The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.
Is John Davidson enrolled in Medicare?
Yes. John Davidson is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for John Davidson was last updated on January 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# John Howard Davidson, PA · NPI 1043480056
Physician Assistant physician in Carbondale, Illinois. Individual provider, active in the CMS NPPES registry since March 5, 2008.
## Identity
- **NPI:** 1043480056 (Entity type: Individual)
- **Enumerated:** March 5, 2008
- **Primary specialty:** Physician Assistant · taxonomy 363A00000X
- **State license:** 085001572 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 405 W JACKSON ST, Carbondale, IL 62901-1462
- **Phone:** (618) 549-0721 · **Fax:** (618) 457-0469
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** January 11, 2021
- **Other identifiers:** Other 085001572 (IL)
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Source: [NPI Profile](https://npiprofile.com/npi/1043480056) · Data from the CMS NPPES public registry.