Active NPI
Ryan Glenn Davis, MD
- Diagnostic Radiology Physician
- Oklahoma City, OK
National Provider Identifier
1124244538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 23595
- Practice address
- 4401 S Western Ave
Oklahoma City, OK 73109-3413 - Phone
- (405) 928-2530
- NPI assigned
- Apr 17, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 23595 | OK | Primary |
Addresses
Primary practice location
4401 S Western Ave
Oklahoma City, OK 73109-3413
Mailing address
PO Box 269065
Oklahoma City, OK 73126-9065
Phone (405) 486-7250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200252290A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- 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 |
|---|---|---|---|---|
| I20090909000737 | OK | Practitioner - Diagnostic Radiology | 1759436082 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Oklahoma College of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone (405) 636-7000
Hospital & facility affiliations
- Integris Southwest Medical Center
- Integris Baptist Medical Center, Inc
- Norman Regional
- SSM Health St Anthony Hospital - Oklahoma City
- Integris Community Hospital - Council Crossing
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.41 of 100
- Quality
- 88.72
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles (1 of 2)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integris Ambulatory Care Corporation | Current | Accepting new patients |
Locations
4401 S Western Ave
Oklahoma City, OK 73109
Phone (405) 636-7000
3400 NW Expressway
Ste 500
Oklahoma City, OK 73112
Phone (405) 945-4589
Networks
- Freedom Health HMO Network
Organizations & group practices 1
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.
Hospital & facility affiliations 14
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Oklahoma City, OK
- NPI 1598837221
Hospital
-
- General Acute Care Hospital
- Oklahoma City, OK
- NPI 1831103654
Hospital
-
- Mammography Clinic/Center
- Oklahoma City, OK
- NPI 1336155779
Hospital
-
- Rehabilitation Hospital Unit
- Oklahoma City, OK
- NPI 1336252717
Hospital
-
- General Acute Care Hospital
- Oklahoma City, OK
- NPI 1457372625
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489622400000",
"number": "1124244538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 269065",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731269065",
"telephone_number": "405-486-7250",
"fax_number": "706-653-1567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 S WESTERN AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731093413",
"telephone_number": "405-928-2530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "RYAN",
"middle_name": "GLENN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-17",
"last_updated": "2017-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OK",
"license": "23595",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200252290A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.