NPIMap

Individual provider Active NPI

Elisa A Davis, MD

  • Pediatrics Physician
  • Stillwater, OK
National Provider Identifier
1508907676
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25157 Issued in OK
Practice address
1201 S Adams St
Stillwater, OK 74074-5476
Phone
(405) 743-7300
Fax
(405) 743-7256
NPI assigned
Feb 9, 2007
Last updated
Mar 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25157 OK
Pediatrics Physician 208000000X 25157 OK Primary

Addresses

Primary practice location

1201 S Adams St
Stillwater, OK 74074-5476

Mailing address

PO Box 720006
Norman, OK 73070-4006
Phone (405) 743-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100907001132 OK Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3072637412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Oklahoma College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1201 S Adams St
Stillwater Pediatrics
Stillwater, OK 74074-5476
Phone (405) 372-1480

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.91 of 100Reported as apm
Quality
76.55
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25157OKMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stillwater Medical Center Authority CurrentSince Dec 7, 2013 Accepting new patients
Stillwater Medical Center Authority Internal Medicine CurrentSince Dec 7, 2013 Accepting new patients
Stillwater Medical Center Authority Past Accepting new patients
Stillwater Medical Center Physicians Internal Medicine Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

417 Fairview Ave
Ponca City, OK 74601
Phone (580) 762-3770

1201 S Adams St
Stillwater, OK 74074
Phone (405) 533-2060

1815 W 6th Ave
Stillwater, OK 74074
Phone (405) 743-7300

Interoperability endpoints

  • Direct secure messaging: elisa.davis.p1@direct.smc.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1508907676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 720006",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730704006",
            "telephone_number": "405-743-7300",
            "fax_number": "405-743-7256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S ADAMS ST",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740745476",
            "telephone_number": "405-743-7300",
            "fax_number": "405-743-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ELISA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "25157",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "25157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

Verify at the official NPI Registry.