Mitchell Ryan Davis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20654 Issued in OK

Practice address

1921 Stonecipher Boulevard
Ada, OK 74820-3439

Phone

(580) 421-6260

Fax

(580) 272-5731

NPI assigned

Dec 22, 2005

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 TX

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

Specialty

Family Practice

Education

Boston University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Chickasaw Nation Division of Health Chickasaw Nation Medical CenterGroup PAC ID 8426957523, 243 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Minticha Apila Home health agency, Ada, OK, CCN 377876
• Chickasaw Nation Medical Center Hospital, Ada, OK, CCN 370180
• Mercy Hospital Ada Hospital, Ada, OK, CCN 370020

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rdavis23507@direct.chickasawnationhealth.net

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.

• Chickasaw Nation Division of Health

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1255364923

  TX

  Medicare reassignment Care Compare group NPD
• Chickasaw Nation Division of Health

  • Home Health Agency
  • Ada, OK
  • NPI 1811739071
  NPD
• Chickasaw Nation Division of Health Chickasaw Nation Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Ada, OK
  • NPI 1295399095
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Chickasaw Nation Division of Health

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1255364923
  Care Compare affiliation
• Chickasaw Nation Division of Health

  • Primary Care Clinic/Center
  • Tishomingo, OK
  • NPI 1649330242

  Hospital

  Care Compare affiliation
• Chickasaw Nation Division of Health

  • Primary Care Clinic/Center
  • Ardmore, OK
  • NPI 1730249186

  Hospital

  Care Compare affiliation
• Chickasaw Nation Division of Health

  • Home Health Agency
  • Ada, OK
  • NPI 1811739071
  Care Compare affiliation
• Chickasaw Nation Division of Health

  • Primary Care Clinic/Center
  • Purcell, OK
  • NPI 1982764395

  Hospital

  Care Compare affiliation
• Chickasaw Nation Division of Health Chickasaw Nation Medical Center

  • Primary Care Clinic/Center
  • Ada, OK
  • NPI 1962563148

  Hospital

  Care Compare affiliation
• Mercy Hospital Ada, Inc

  • Ambulance
  • Ada, OK
  • NPI 1831533728

  Hospital

  Care Compare affiliation
• Mercy Hospital Ada, Inc

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1952643306
  Care Compare affiliation

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1346227113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER BLVD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203439",
            "telephone_number": "580-421-4570",
            "fax_number": "580-272-5731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER BOULEVARD",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203439",
            "telephone_number": "580-421-6260",
            "fax_number": "580-272-5731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MITCHELL",
        "middle_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "20654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Wesley Davies, MD
• Anthony Ray Davis
• Clancy Davis
• Joseph Davis
• Marc J Davis, D.O.
• Paul Davis
• Rachael J Davis, PTA
• Stacy Davis
• Tami Davis
• Shannon Deatherage, BSW

• Family Medicine Physician in Ada, OK
• Providers in Ada, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.

Verify at the official NPI Registry.