Blake Davis

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-22-63002 Issued in OK

Practice address

2208 W Detroit St
Broken Arrow, OK 74012-3629

Phone

(918) 900-6237

NPI assigned

Oct 12, 2020

Last updated

Dec 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Spectrum of Hope, LLC

  dba Soh Kids

  • Multi-Specialty Clinic/Center
  • Tulsa, OK
  • NPI 1669983409

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1003414194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 W DETROIT ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123629",
            "telephone_number": "918-900-6237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2208 W DETROIT ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740123629",
            "telephone_number": "918-900-6237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "BLAKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-12",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OK",
            "license": "1-22-63002",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa David, CLC
• Richard David Davidson, MS, LADC, CRC, CVRT,
• Amanda Davies, M.ED. CCC
• Joseph William Davies Sr., PHARMACIST
• Raeleen Jenell Davis-Perry
• Darrick Davis, DC
• Heather Brooke Davis
• Jefferey L Davis, D.O.
• Jonathan Charles Davis
• Laura B Davis, RPTA

• Behavior Analyst in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Behavior Analyst in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.