Individual provider Active NPI

Ashley Davis, M.D.

  • Pediatrics Physician
  • Sherwood, AR
National Provider Identifier
1114960218
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
E-4072 Issued in AR
Practice address
1308 E Kiehl Ave
Sherwood, AR 72120-3040
Phone
(501) 835-0703
Fax
(501) 834-6249
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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-4072 AR Primary

Addresses

Primary practice location

1308 E Kiehl Ave
Sherwood, AR 72120-3040

Mailing address

1308 E Kiehl Ave
Sherwood, AR 72120-3040
Phone (501) 835-0703

Other identifiers 4

IdentifierTypeStateIssuer
652570OtherARHEALTHLINK
06030016300OtherARQUALCHOICE
154253001MedicaidAR
5M900OtherARBLUE CROSS

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
I20040628000877 AR Practitioner - Pediatric Medicine 3577549716 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-4072ARMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Health Group Pediatrics CurrentSince Feb 15, 2010 Accepting new patients
Arkansas Health Group CurrentSince Feb 15, 2010 Accepting new patients
Arkansas Health Group Past Accepting new patients

Locations

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

1308 E Kiehl Ave
Sherwood, AR 72120
Phone (501) 835-0703

Interoperability endpoints

  • Direct secure messaging: adavis3068@direct.baptist-healthar.org

Organizations & group practices 3

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1114960218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 E KIEHL AVE",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721203040",
            "telephone_number": "501-835-0703",
            "fax_number": "501-834-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 E KIEHL AVE",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721203040",
            "telephone_number": "501-835-0703",
            "fax_number": "501-834-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E-4072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "652570",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "06030016300",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154253001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "5M900",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherwood, AR

Sources for this page

Verify at the official NPI Registry.