Active NPI
R Keith Davis Jr., M.D.
- Family Medicine Physician
- Smackover, AR
National Provider Identifier
1104826320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- E3055
- Practice address
- 1400 Pershing Hwy
Smackover, AR 71762-2300 - Phone
- (870) 725-3471
- Fax
- (870) 725-3215
- NPI assigned
- Jul 29, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
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.
-
- Family Medicine Physician
- El Dorado, AR
- NPI 1427018704
Family Medicine
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- El Dorado, AR
- NPI 1285659409
-
- General Acute Care Hospital
- El Dorado, AR
- NPI 1780375592
Hospital
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Arkansas College of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1400 Pershing Hwy
Smackover, AR 71762-2300
Phone (870) 725-3471
Hospital & facility affiliations
- South Arkansas Home Health
- South Arkansas Regional Hospital LLC
- Baptist Health Medical Center-Little Rock
- Ouachita County Medical Center
- Bradley County Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 29.48 of 100
- Quality
- 15
- Improvement activities
- 0
- Cost
- 78.28
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 84 |
| Removal of nail tissue | 1-10 |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040220000216 | AR | Practitioner - Family Practice | 8224923966 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| R Keith Davis MD PLLC PA | Family Medicine | Current | Accepting new patients |
| Richard K Davis MD PLLC PA | Family Medicine | Current | Accepting new patients |
| R Keith Davis MD PLLC PA | Family Medicine | Current | Accepting new patients |
| Clint a Netherland, MD, PLLC | Family Medicine | Current | Accepting new patients |
| South Arkansas Physician Services LLC | Family Medicine | Past | Accepting new patients |
Locations
1400 Pershing Hwy
Smackover, AR 71762
Phone (870) 725-3471
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | E3055 | AR | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
1400 Pershing Hwy
Smackover, AR 71762-2300
Mailing address
PO Box 69
Smackover, AR 71762-0069
Phone (870) 725-3471
Other identifiers 3
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| A002 | Other | AR | TRICARE |
| 5M036 | Other | AR | BCBS |
| 145479001 | Medicaid | AR |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 21, 2013.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361404800000",
"number": "1104826320",
"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": {
"last_name": "DAVIS",
"first_name": "R",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-29",
"last_updated": "2013-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "E3055",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "A002",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5M036",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "145479001",
"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 Feb 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.