Active NPI
Lacy S Davis, MD
- Pediatrics Physician
- Edmond, OK
National Provider Identifier
1265793947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 29259
- Practice address
- 2017 W I 35 Frontage Rd
Suite 150
Edmond, OK 73013-8504 - Phone
- (405) 757-3365
- Fax
- (405) 757-3366
- NPI assigned
- May 30, 2012
- Last updated
- Jan 13, 2017
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 29259 | OK | Primary |
Addresses
Primary practice location
2017 W I 35 Frontage Rd
Suite 150
Edmond, OK 73013-8504
Mailing address
2017 W I 35 Frontage Rd
Suite 150
Edmond, OK 73013-8504
Phone (405) 757-3365
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29259 | OK | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lacy Davis MD PLLC | Pediatrics | Current | Accepting new patients |
| Integris South Oklahoma City Hospital Corporation | Past | Accepting new patients | |
| Mercy Hospital Oklahoma City, Inc | Past | Accepting new patients | |
| Integris Baptist Medical Center Inc | Past | Accepting new patients |
Interoperability endpoints
- ldavis721706@directa.mercy.net
Organizations & group practices 4
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.
-
- Pediatrics Physician
- Luther, OK
- NPI 1053914036
-
dba Integris Health Baptist Medical Center
- General Acute Care Hospital
- Oklahoma City, OK
- NPI 1831103654
-
dba Integris Health Southwest Medical Center
- General Acute Care Hospital
- Oklahoma City, OK
- NPI 1457372625
-
- Diagnostic Radiology Physician
- Yukon, OK
- NPI 1730326406
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484265600000",
"number": "1265793947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2017 W I 35 FRONTAGE RD",
"address_2": "SUITE 150",
"city": "EDMOND",
"state": "OK",
"postal_code": "730138504",
"telephone_number": "405-757-3365",
"fax_number": "405-757-3366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2017 W I 35 FRONTAGE RD",
"address_2": "SUITE 150",
"city": "EDMOND",
"state": "OK",
"postal_code": "730138504",
"telephone_number": "405-757-3365",
"fax_number": "405-757-3366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LACY",
"middle_name": "S",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-30",
"last_updated": "2017-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OK",
"license": "29259",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.