Active NPI
Lauren Davis, MD
- Child & Adolescent Psychiatry Physician
- Conway, AR
National Provider Identifier
1417311770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- E-11037
- Practice address
- 2215 E Oak St Ste 1
Conway, AR 72032-4644 - Phone
- (501) 336-0511
- Fax
- (501) 336-4037
- NPI assigned
- Apr 12, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | E-11037 | AR | Primary |
Addresses
Primary practice location
2215 E Oak St Ste 1
Conway, AR 72032-4644
Mailing address
2215 E Oak St Ste 1
Conway, AR 72032-4644
Phone (501) 336-0511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160720000342 | AR | Order and Referring Only - Psychiatry | 5092008615 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-11037 | AR | MD | Child & Adolescent Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632268800000",
"number": "1417311770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 E OAK ST STE 1",
"city": "CONWAY",
"state": "AR",
"postal_code": "720324644",
"telephone_number": "501-336-0511",
"fax_number": "501-336-4037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 E OAK ST STE 1",
"city": "CONWAY",
"state": "AR",
"postal_code": "720324644",
"telephone_number": "501-336-0511",
"fax_number": "501-336-4037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "LAUREN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-12",
"last_updated": "2021-09-22",
"certification_date": "2021-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "AR",
"license": "E-11037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.