Active NPI
Russell Davis, DO
- Neonatal-Perinatal Medicine Physician
- Tulsa, OK
National Provider Identifier
1619504214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 012383
- Practice address
- 717 S Houston Ave Ste 400
Tulsa, OK 74127-9007 - Phone
- (918) 382-4600
- NPI assigned
- Mar 24, 2020
- Last updated
- Jun 5, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 012383 | AZ | Primary |
Addresses
Primary practice location
717 S Houston Ave Ste 400
Tulsa, OK 74127-9007
Mailing address
1331 E Purdue Ave Apt a
Phoenix, AZ 85020-6233
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012383 | AZ | MD | Neonatal-Perinatal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780617600000",
"number": "1619504214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1331 E PURDUE AVE APT A",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850206233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "717 S HOUSTON AVE STE 400",
"city": "TULSA",
"state": "OK",
"postal_code": "741279007",
"telephone_number": "918-382-4600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "RUSSELL",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-24",
"last_updated": "2026-06-05",
"certification_date": "2026-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "AZ",
"license": "012383",
"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, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.