Individual provider Active NPI

Orrin J Davis, MD

  • Pediatrics Physician
  • Fayetteville, AR
National Provider Identifier
1083669329
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
E-4833 Issued in AR
Practice address
3380 N Futrall Dr Ste 1
Fayetteville, AR 72703
Phone
(479) 442-7322
Fax
(479) 442-7379
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X E-4833 AR Primary

Addresses

Primary practice location

3380 N Futrall Dr Ste 1
Fayetteville, AR 72703

Mailing address

PO Box 1523
Fayetteville, AR 72702-1523
Phone (479) 571-6038

Other practice location 1

3383 N Mana Ct Ste 101
Fayetteville, AR 72703-4965
Phone (479) 443-3471

Other identifiers 2

IdentifierTypeStateIssuer
5N574OtherARAR BCBS
161468001MedicaidAR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address orrin.davis@mana.eclinicaldirectplus.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060824000006 AR Practitioner - Pediatric Medicine 7810957917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Creighton University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3344 N Futrall Dr
Fayetteville, AR 72703-4057
Phone (479) 521-8200

3380 N Futrall Dr
Suite 1
Fayetteville, AR 72703-4815
Phone (479) 442-7322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-4833ARMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Northwest Arkansas, PA CurrentSince Jul 1, 2013 Accepting new patients
Medical Associates of Northwest Arkansas PA Pediatrics Past Accepting new patients
Medical Associates of Northwest Arkansas PA Past Accepting new patients
Medical Associates of Northwest Arkansas PA Past Accepting new patients

Locations

3380 N Futrall Dr
Ste 1
Fayetteville, AR 72703
Phone (479) 442-7322

3344 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 582-7213

3383 N Mana Ct
Ste 101
Fayetteville, AR 72703
Phone (479) 442-7322

3730 S Pinnacle Hills Pkwy
#3
Rogers, AR 72758
Phone (479) 464-5597

3730 S Pinnacle Hills Pkwy
Ste 3
Rogers, AR 72758
Phone (479) 221-8902

Interoperability endpoints

  • Direct secure messaging: orrin.davis@mana.eclinicaldirectplus.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1083669329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1523",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727021523",
            "telephone_number": "479-571-6038",
            "fax_number": "479-582-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 N FUTRALL DR STE 1",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-442-7322",
            "fax_number": "479-442-7379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3383 N Mana Ct Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727034965",
            "country_code": "US",
            "telephone_number": "479-443-3471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ORRIN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-4833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BCBS",
            "identifier": "5N574",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161468001",
            "state": "AR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "orrin.davis@mana.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "orrin.davis@mana.eclinicaldirectplus.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "3380 N Futrall Dr Ste 1",
            "city": "Fayetteville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "72703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.