Individual provider Active NPI

Ryan Gerald Davis, APRN, FNP-C

  • Family Nurse Practitioner
  • Bountiful, UT
National Provider Identifier
1639823362
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10374552-3102 Issued in UT
Practice address
520 Medical Dr Ste 300
Bountiful, UT 84010-8925
Phone
(801) 292-1422
NPI assigned
Feb 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10374552-3102 UT Primary

Addresses

Primary practice location

520 Medical Dr Ste 300
Bountiful, UT 84010-8925

Mailing address

520 Medical Dr Ste 300
Bountiful, UT 84010-8925
Phone (801) 292-1422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20230301000343 UT Practitioner - Nurse Practitioner 1355714007 Reassigns benefits to 3 organizations

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
Joshua Oaks MD PLLCGroup PAC ID 0840776688, 31 clinicians

Practice addresses (Care Compare)

520 Medical Dr
Suite 300
Bountiful, UT 84010-8925
Phone (801) 292-1422

Hospital & facility affiliations

  • Lakeview Hospital Hospital, Bountiful, UT, CCN 460042

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10374552-3102UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Joshua Oaks MD PLLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

520 Medical Dr
Ste 300
Bountiful, UT 84010
Phone (801) 292-1422

763 N Redwood Rd
Ste 110
North Salt Lake, UT 84054
Phone (801) 292-1423

Interoperability endpoints

  • Direct secure messaging: ryan.davis.1@16218.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1639823362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MEDICAL DR STE 300",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108925",
            "telephone_number": "801-292-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MEDICAL DR STE 300",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108925",
            "telephone_number": "801-292-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RYAN",
        "middle_name": "GERALD",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-10",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "10374552-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.