Cross-source identifiers
Every current identifier attachment, with the link method and confidence carried verbatim — deterministic links are 1.000; probabilistic links surface their real matcher confidence, never rounded up.
| Scheme | Value | Source table | Link method | Confidence | Since | Provenance |
|---|---|---|---|---|---|---|
| cms_op_profile_id | 11123531 | cms_open_payments | exact_npi_in_open_payments | 1.000 | 2026-06-13 | evidencerecorded: 2026-06-13 methodology: entity-graph/v1 evidence: {"npi":"1104887918","rule":"D-OP-NPI","recipient_profile_id":"11123531"} |
| npi | 1104887918 | nppes_providers | deterministic_pk | 1.000 | 2026-06-11 | evidencerecorded: 2026-06-11 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1104887918","entity_type_code":"1"} |
| pac_id | 4789585076 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-12 | evidencerecorded: 2026-06-12 methodology: entity-graph/v1 evidence: {"npi":"1104887918","rule":"D-PECOS","enrlmt_id":"I20040120000006","pecos_asct_cntl_id":"4789585076"} |
| pecos_enrlmt_id | I20040120000006 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-12 | evidencerecorded: 2026-06-12 methodology: entity-graph/v1 evidence: {"npi":"1104887918","rule":"D-PECOS","enrlmt_id":"I20040120000006"} |
Graph edges
One-hop relationships — ownership, chain membership, operation — each backed by a federal source row.
| Relationship | Entity | Confidence | Source table | Provenance |
|---|---|---|---|---|
| ← pays | Novo Nordisk Inc (NJ) | 1.000 | cms_open_payments | evidencerecorded: 2026-06-13 methodology: entity-graph/v1 attributes: {"source":"cms_open_payments"} evidence: {"rule":"D-OP-PAYS","record_type":"general","recipient_npi":"1104887918","manufacturer_id":"100000000144","nature_of_payment":"Food and Beverage"} |
| ← pays | ABBVIE INC. (IL) | 1.000 | cms_open_payments | evidencerecorded: 2026-06-13 methodology: entity-graph/v1 attributes: {"source":"cms_open_payments"} evidence: {"rule":"D-OP-PAYS","record_type":"general","recipient_npi":"1104887918","manufacturer_id":"100000000204","nature_of_payment":"Food and Beverage"} |
| ← pays | Insulet Corporation (MA) | 1.000 | cms_open_payments | evidencerecorded: 2026-06-13 methodology: entity-graph/v1 attributes: {"source":"cms_open_payments"} evidence: {"rule":"D-OP-PAYS","record_type":"general","recipient_npi":"1104887918","manufacturer_id":"100000005484","nature_of_payment":"Food and Beverage"} |
| ← pays | Medtronic, Inc. (MN) | 1.000 | cms_open_payments | evidencerecorded: 2026-06-13 methodology: entity-graph/v1 attributes: {"source":"cms_open_payments"} evidence: {"rule":"D-OP-PAYS","record_type":"general","recipient_npi":"1104887918","manufacturer_id":"100000000106","nature_of_payment":"Food and Beverage"} |
| ← pays | Amgen Inc. (CA) | 1.000 | cms_open_payments | evidencerecorded: 2026-06-13 methodology: entity-graph/v1 attributes: {"source":"cms_open_payments"} evidence: {"rule":"D-OP-PAYS","record_type":"general","recipient_npi":"1104887918","manufacturer_id":"100000000203","nature_of_payment":"Food and Beverage"} |
| ← pays | PFIZER INC. (NY) | 1.000 | cms_open_payments | evidencerecorded: 2026-06-13 methodology: entity-graph/v1 attributes: {"source":"cms_open_payments"} evidence: {"rule":"D-OP-PAYS","record_type":"general","recipient_npi":"1104887918","manufacturer_id":"100000000286","nature_of_payment":"Food and Beverage"} |
| ← pays | Ascendis Pharma Inc (CA) | 1.000 | cms_open_payments | evidencerecorded: 2026-06-14 methodology: entity-graph/v1 attributes: {"source":"cms_open_payments"} evidence: {"rule":"D-OP-PAYS","record_type":"general","recipient_npi":"1104887918","manufacturer_id":"100000941823","nature_of_payment":"Food and Beverage"} |
| ← pays | Lilly USA, LLC (IN) | 1.000 | cms_open_payments | evidencerecorded: 2026-06-14 methodology: entity-graph/v1 attributes: {"source":"cms_open_payments"} evidence: {"rule":"D-OP-PAYS","record_type":"general","recipient_npi":"1104887918","manufacturer_id":"100000000066","nature_of_payment":"Food and Beverage"} |
| ← pays | Dexcom, Inc. (CA) | 1.000 | cms_open_payments | evidencerecorded: 2026-06-14 methodology: entity-graph/v1 attributes: {"source":"cms_open_payments"} evidence: {"rule":"D-OP-PAYS","record_type":"general","recipient_npi":"1104887918","manufacturer_id":"100000010478","nature_of_payment":"Food and Beverage"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
provider · 1104887918 JSON
| Metric | Value | Asserted | Source |
|---|---|---|---|
| credential | PA-C | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| enumeration_date | 2006-03-31 | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| first_name | SHANA | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| last_name | DAVIDSON | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| practice_state | PA | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| primary_taxonomy | 363AM0700X | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| years_active | 19 years | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
Provider screening signals
NPI-keyed source families read directly for 1104887918: federal and state integrity lists, CMS Open Payments, Order and Referring eligibility, Medicare opt-out, and enrollment revalidation. Cells expose the source and provenance fields supplied by the selected record. A screening aid — re-confirm any match against the primary source before acting; absence means nothing on file in the data Fonteum currently holds, never a guarantee none exists.
Sanctions & integrity
Coverage staleExclusion coverage is stale or cannot be reconciled to an attested source artifact. This result is indeterminate and must not be treated as a clearance; check the current issuing-agency lists.
- Coverage status: indeterminate
- Screened 26 integrity lists; no negative determination was made.
14-tuple provenance (26)
Industry payments
On file66 CMS Open Payments records on file. Ask Fonteum for the largest payments and a cited total.
14-tuple provenance (1)
Order & referring eligibility
On fileOn the CMS Order and Referring roster — eligible to order and refer in 4 of 5 Medicare benefit categories.
- Part B: Y
- DME: Y
- HHA: Y
- PMD: Y
- Hospice: N
14-tuple provenance (1)
Medicare opt-out
None on fileNo CMS Medicare opt-out affidavit on file for this NPI.
14-tuple provenance (1)
Revalidation
On file1 Medicare enrollment record on file.
- Due date: TBD upstream — not due within the ensuing six months.
14-tuple provenance (1)
Point-in-time
Query retained claim coordinates under bitemporal-read/v1. Most facts have no superseded row; dates outside retained coverage may return no prior version, and diffs require both coordinates.
Pick a date to reconstruct, or two dates to diff. Equivalent JSON: /api/v1/history/{subject_type}/{subject_id}?at=… and …/diff?from=…&to=…