NPIMap

Organization Active NPI

Richard K Davis MD PLLC PA

  • Family Medicine Physician
  • Smackover, AR
National Provider Identifier
1003149493
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C6398 Issued in AR
Legal business name
RICHARD K DAVIS MD PLLC PA
Practice address
1400 Pershing Hwy
Smackover, AR 71762-2300
Phone
(870) 725-3471
Fax
(870) 725-3215
NPI assigned
Sep 16, 2009
Last updated
Sep 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Richard K Davis Sr., M.D.
Title
Sole Member
Phone
(870) 725-3471

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C6398 AR Primary

Addresses

Primary practice location

1400 Pershing Hwy
Smackover, AR 71762-2300

Mailing address

PO Box 69
Smackover, AR 71762-0069
Phone (870) 725-3471

Other identifiers 2

IdentifierTypeStateIssuer
51303OtherBCBS
106187001MedicaidAR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1003149493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "SMACKOVER",
            "state": "AR",
            "postal_code": "717620069",
            "telephone_number": "870-725-3471",
            "fax_number": "870-725-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PERSHING HWY",
            "city": "SMACKOVER",
            "state": "AR",
            "postal_code": "717622300",
            "telephone_number": "870-725-3471",
            "fax_number": "870-725-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD K DAVIS MD PLLC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-16",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "870-725-3471",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C6398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51303",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106187001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smackover, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.