Susan Lynne Davis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA533 Issued in OK

Practice address

1429 Pennsylvania Ave
Hartshorne, OK 74547-3839

Phone

(918) 297-2403

Fax

(918) 426-0888

NPI assigned

Oct 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Susan Lynne Brady Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Caring Hands Healthcare Centers, IncGroup PAC ID 1456455575, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lifespring Home Care of McAlester Home health agency, McAlester, OK, CCN 377756
• McAlester Regional Health Center Hospital, McAlester, OK, CCN 370034

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: susan.davis.p1@direct.chhcok.nextgenshare.com

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.

• Caring Hands Healthcare Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Hartshorne, OK
  • NPI 1346324134
  Medicare reassignment Care Compare group NPD
• McAlester Regional Health Center Authority

  • Rural Acute Care Hospital
  • McAlester, OK
  • NPI 1316940034
  Medicare reassignment NPD
• Caring Hands Healthcare Centers Inc

  • Federally Qualified Health Center (FQHC)
  • McAlester, OK
  • NPI 1538748538
  NPD
• Caring Hands Healthcare Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • McAlester, OK
  • NPI 1942435672

  Medical

  NPD (past)
• McAlester Care Associates

  • Urgent Care Clinic/Center
  • McAlester, OK
  • NPI 1609025873
  NPD (past)

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

• McAlester Regional Health Center Authority

  • Rural Acute Care Hospital
  • McAlester, OK
  • NPI 1316940034
  Care Compare affiliation
• Vahlberg Enterprises, LLC

  • Home Health Agency
  • McAlester, OK
  • NPI 1851689426
  Care Compare affiliation

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1386734614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1992",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745021992",
            "telephone_number": "918-426-2442",
            "fax_number": "918-426-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1429 PENNSYLVANIA AVE",
            "city": "HARTSHORNE",
            "state": "OK",
            "postal_code": "745473839",
            "telephone_number": "918-297-2403",
            "fax_number": "918-426-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SUSAN",
        "middle_name": "LYNNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "PA533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200047790A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "BRADY",
            "middle_name": "LYNNE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Azaleah Carpenter, RN
• City of Hartshorne
• Destiny Clifft
• Community Counselors Group Inc
• Community Counselors Group Inc.
• Nelson Eddie Dickenson, B.A. , C.M. , R.S.S.
• Dow Residential Care Facility Inc
• Rhonda Anne Dugan
• Lexie Encisos Franco
• Jayme C Goad

• Medical Physician Assistant in Hartshorne, OK
• Providers in Hartshorne, OK by specialty
• Medical Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; 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.