Individual provider Active NPI

Renee Davis, APRN

  • Adult Health Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1558084590
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
210399 Issued in OK
Practice address
2000 S Wheeling Ave Ste 510
Tulsa, OK 74104-5642
Phone
(918) 747-5200
Fax
(918) 858-0290
NPI assigned
Sep 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 210399 OK Primary

Addresses

Primary practice location

2000 S Wheeling Ave Ste 510
Tulsa, OK 74104-5642

Mailing address

1921 E 133Rd CT
Bixby, OK 74008-1089
Phone (918) 798-0790

Other practice location 1

2202 E 49th St Ste 600
Tulsa, OK 74105-8716
Phone (918) 798-0790

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230206003031 OK Practitioner - Nurse Practitioner 4082086798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nephrology Associates, Inc.Group PAC ID 9234020629, 21 clinicians

Practice addresses (Care Compare)

2000 S Wheeling Ave
Suite 510
Tulsa, OK 74104-5642
Phone (918) 747-5200

Hospital & facility affiliations

  • Saint Francis Hospital Muskogee Hospital, Muskogee, OK, CCN 370025
  • Cherokee Nation W W Hastings Indian Hospital Hospital, Tahlequah, OK, CCN 370171
  • Ascension St John Medical Center Hospital, Tulsa, OK, CCN 370114
  • Ascension St John Broken Arrow Hospital, Broken Arrow, OK, CCN 370235
  • Stillwater Medical Center Hospital, Stillwater, OK, CCN 370049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
210399OKMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates, Inc. CurrentSince Dec 5, 2022 Accepting new patients

Locations

3500 State St
Bartlesville, OK 74006
Phone (918) 224-9620

Dept 515
Tulsa, OK 74182

2000 S Wheeling Ave
Ste 510
Tulsa, OK 74104
Phone (918) 747-5200

Interoperability endpoints

  • Direct secure messaging: rdavis47354@direct.acumenmd.com

Organizations & group practices 1

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.

Hospital & facility affiliations 7

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": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1558084590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 E 133RD CT",
            "city": "BIXBY",
            "state": "OK",
            "postal_code": "740081089",
            "telephone_number": "918-798-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S WHEELING AVE STE 510",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741045642",
            "telephone_number": "918-747-5200",
            "fax_number": "918-858-0290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2202 E 49th St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741058716",
            "country_code": "US",
            "telephone_number": "918-798-0790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OK",
            "license": "210399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.