Individual provider Active NPI

Christine Ann Davis

  • Pediatric Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1295284743
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
134008 Issued in OK
Practice address
6465 S Yale Ave Ste 408
Tulsa, OK 74136-7806
Phone
(918) 481-4880
Fax
(918) 481-4899
NPI assigned
Sep 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 21865 TN
Pediatric Nurse Practitioner 363LP0200X 134008 OK Primary

Addresses

Primary practice location

6465 S Yale Ave Ste 408
Tulsa, OK 74136-7806

Mailing address

6465 S Yale Ave Ste 408
Tulsa, OK 74136-7806
Phone (615) 481-4880

Other practice location 1

1029 W Main St
Suite M
Lebanon, TN 37087-3351
Phone (615) 453-1252

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
134008OKMDPediatric Nurse Practitioner
21865TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franz Moncada MD Inc PastSince Sep 15, 2019 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568246400000",
    "number": "1295284743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE STE 408",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367806",
            "telephone_number": "615-481-4880",
            "fax_number": "918-481-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE STE 408",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367806",
            "telephone_number": "918-481-4880",
            "fax_number": "918-481-4899"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1029 W Main St",
            "address_2": "Suite M",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "TN",
            "postal_code": "370873351",
            "country_code": "US",
            "telephone_number": "615-453-1252",
            "fax_number": "615-453-1286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHRISTINE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-26",
        "last_updated": "2019-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "21865",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "134008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.