Individual provider Active NPI

Darrin Alexander Davis, DO

  • Family Medicine Physician
  • Olathe, KS
National Provider Identifier
1104879295
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0526609 Issued in KS
Practice address
15710 W 135TH St Ste 200
Olathe, KS 66062-1508
Phone
(913) 297-7472
Fax
(844) 413-7208
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2021042797 MO
Family Medicine Physician 207Q00000X 0526609 KS Primary

Addresses

Primary practice location

15710 W 135TH St Ste 200
Olathe, KS 66062-1508

Mailing address

15710 W 135TH St Ste 200
Olathe, KS 66062-1508
Phone (913) 297-7472

Other identifiers 1

IdentifierTypeStateIssuer
100317360AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20220120002389 KS Order and Referring Only - Family PracticePractitioner - Family Practice 9234271487

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0526609KSMDFamily Medicine Physician
2021042797MOMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: darrin.davis.1@16552.direct.athenahealth.com
  • Direct secure messaging: ddavis755562@direct.kuha.org

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1104879295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15710 W 135TH ST STE 200",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621508",
            "telephone_number": "913-297-7472",
            "fax_number": "844-413-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15710 W 135TH ST STE 200",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621508",
            "telephone_number": "913-297-7472",
            "fax_number": "844-413-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DARRIN",
        "middle_name": "ALEXANDER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2021042797",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0526609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100317360A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.