Individual provider Active NPI

Jessica Davis, DPT

  • Physical Therapist
  • Tulsa, OK
National Provider Identifier
1417486366
Registry record updated Jun 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5287 Issued in OK
Practice address
4008 S Yale Ave
Tulsa, OK 74135-6017
Phone
(918) 622-4278
Fax
(918) 622-4844
NPI assigned
Jun 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5287 OK Primary

Addresses

Primary practice location

4008 S Yale Ave
Tulsa, OK 74135-6017

Mailing address

4812 E 33Rd St
Tulsa, OK 74135-2038
Phone (918) 622-4126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170624000143 OK Practitioner - Physical Therapist in Private Practice 8628346160 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Oklahoma LLC Physical Therapist Current Accepting new patients
Drayer Physical Therapy Oklahoma LLC Physical Therapist CurrentSince Jan 17, 2018 Accepting new patients
Drayer Physical Therapy Oklahoma LLC Physical Therapist CurrentSince Jan 17, 2018 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

2560 E Kenosha St
Broken Arrow, OK 74014
Phone (918) 994-7864

1355 W Rogers Blvd
Ste 10
Skiatook, OK 74070
Phone (918) 396-7125

Organizations & group practices 3

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": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496620800000",
    "number": "1417486366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4812 E 33RD ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352038",
            "telephone_number": "918-622-4126",
            "fax_number": "918-270-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4008 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356017",
            "telephone_number": "918-622-4278",
            "fax_number": "918-622-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JESSICA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2017-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "5287",
            "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 Jun 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.