Amy Kathleen Davis, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD108105 Issued in MO

Practice address

1008 Rock Creek Elementary School Dr
O Fallon, MO 63366-7576

Phone

(636) 281-4410

Fax

(636) 281-4412

NPI assigned

Apr 11, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 6, 2015 through Jan 6, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245453844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 ROCK CREEK ELEMENTARY SCHOOL DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633667576",
            "telephone_number": "636-281-4410",
            "fax_number": "636-281-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 ROCK CREEK ELEMENTARY SCHOOL DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633667576",
            "telephone_number": "636-281-4410",
            "fax_number": "636-281-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AMY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "MD108105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Daugherty, LPC
• Davenport Chiropractic LLC
• David Hadden, LLC
• Laura L Davidson
• Allison Ann Davis, MSW, LCSW
• Kiara Davis
• Davis, Wright, Berdy & Suffian PC (Allergy Consultants)
• Natalie Day, RD, LD
• DDK LC
• DDK, LC

• Internal Medicine Physician in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Internal Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.