CMS-1500 Box 24J / 33a • NPI
1184631095
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
207PE0004X (CMS 93)
Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)
Box 32 Service Location & ZIP+4
212 S SULLIVAN AVE, FREMONT, MI, 49412-1548
✓ 9-Digit EDI 837 ZIP+4 (49412-1548)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1184631095 (ROBERT M DAVIDSON, MD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
✓ Eligible
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1184631095)
Medicare Beneficiaries
99
Total Billed Services
108
Distinct CPT/HCPCS Codes
7
Medicare Allowed Total
$16,360.80
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
99284 | Emergency department visit with moderate level of medical decision making | 40 |
99285 | Emergency department visit with high level of medical decision making | 39 |
99291 | Critical care, first 30-74 minutes | 18 |
Actual Top Prescribed Medications (CMS Part D)
| Brand / Generic Medication | Total Claims | Patients |
|---|---|---|
| Cefuroxime Cefuroxime Axetil | 23 | 23 |
| Cephalexin Cephalexin | 13 | 13 |
| Prednisone Prednisone | 28 | 28 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1184631095 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | ROBERT M DAVIDSON, MD |
| Plain-English Specialty | Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) NUCC Code: 207PE0004X (Emergency Medicine, Emergency Medical Services) |
| Certifying / Licensing Body | American Board of Emergency Medicine (ABEM) |
| Practice Location Address | 212 S SULLIVAN AVE, FREMONT, MI, 49412-1548 |
| Practice Telephone / Fax | Tel: (231) 924-1300 |
| Administrative Mailing Address | 4100 EMBASSY DR SE STE 400, GRAND RAPIDS, MI, 49546-2416 |
| Enumeration & Last Sync | Enumerated: 2006-08-02 | CMS Record Updated: 2025-02-26 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (207PE0004X)
What Does Taxonomy Code 207PE0004X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207PE0004X translates to:
"Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ROBERT M DAVIDSON, MD)
Typical CPT / Diagnostic Procedures:- Level 4 & Level 5 Emergency Department Resuscitation (CPT 99284–99285)
- Point-of-Care Emergency Ultrasound (eFAST), Intubation & Central Line Placement
- Acute Laceration Repair, Tetanus Prophylaxis & Fracture Splinting
- Epinephrine Auto-Injectors / IV Infusions, Atropine & Amiodarone
- Tetanus Toxoid / Tdap & Tetanus Immunoglobulin (TIG)
- Empiric Sepsis Antibiotics, Parenteral Ketorolac & Ondansetron
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207L00000X — AnesthesiologyPlain English: Board-Certified Anesthesiologist & Interventional Pain Specialist | State: MI | License: 4301077336 | Primary: Secondary |
207P00000X — Emergency MedicinePlain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) | State: IN | License: 01095350A | Primary: Secondary |
207PE0004X — Emergency Medicine, Emergency Medical ServicesPlain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor) | State: MI | License: 4301077336 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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