Wilson L Davis, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

34304 Issued in OK

Practice address

610 E 24TH St
Tishomingo, OK 73460

Phone

(580) 371-2343

Fax

(580) 371-3614

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73380

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 Health Center of Southern Oklahoma Inc

  • Federally Qualified Health Center (FQHC)
  • Tishomingo, OK
  • NPI 1598803942
  Medicare reassignment NPD
• Family Health Center of Southern Oklahoma Inc

  • Federally Qualified Health Center (FQHC)
  • Atoka, OK
  • NPI 1659797314
  NPD
• Family Health Center of Southern Oklahoma Inc

  • Federally Qualified Health Center (FQHC)
  • Milburn, OK
  • NPI 1669321824
  NPD
• Internal Medicine of Keokuk PC

  • Specialist
  • Keokuk, IA
  • NPI 1184627689

  Internal Medicine

  NPD

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1184633521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 E 24TH ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734603245",
            "telephone_number": "580-371-2343",
            "fax_number": "580-371-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E 24TH ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "73460",
            "telephone_number": "580-371-2343",
            "fax_number": "580-371-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "WILSON",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "34304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Cripps, RN
• Ladonna Culp, APRN
• Tasha Cummins, APRN-CNP
• Katrina J Darcey, DDS
• Jana Darnall, M.ED.
• Pamela Diane Dellinger
• Dennis Ventures Inc
• Dennis Ventures Inc
• Chase William Dickerson
• Andrew Christopher Dickmeyer, BLC, BA

• Internal Medicine Physician in Tishomingo, OK
• Providers in Tishomingo, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.