Individual provider Active NPI

James R. Davis, D.O.

  • Emergency Medicine Physician
  • Mustang, OK
National Provider Identifier
1720074081
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
3657 Issued in OK
Practice address
5525 Hidden Meadow Dr
Mustang, OK 73064-9684
Phone
(405) 376-5121
NPI assigned
Sep 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 3657 OK
Emergency Medicine Physician 207P00000X 3657 OK Primary

Addresses

Primary practice location

5525 Hidden Meadow Dr
Mustang, OK 73064-9684

Mailing address

5525 Hidden Meadow Dr
Mustang, OK 73064-9684
Phone (405) 376-5121

Other identifiers 1

IdentifierTypeStateIssuer
100103050CMedicaidOK

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041209000238 OK Practitioner - Emergency Medicine 5698731891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
58.88 of 100Reported as individual
Quality
32.85
Improvement activities
40
Cost
76.78

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Emergency Services PC Emergency Medicine CurrentSince Jan 1, 2011 Accepting new patients
Emergency Services of Oklahoma PC Emergency Medicine CurrentSince Jan 1, 2011 Accepting new patients
Lightstar Emergency Physicians, PLLC Emergency Medicine Past Accepting new patients
Integris Canadian Valley Hospital Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Discovery Medical Diagnostic Group, LLC PastSince Aug 20, 2018 Accepting new patients
Jackson County Memorial Hospital Authority PastSince Dec 31, 2008 Accepting new patients
Norstar Emergency Physicians Emergency Medical Services Past Accepting new patients

Locations

3401 W Gore Blvd
Lawton, OK 73505
Phone (580) 483-5207

901 N Porter Ave
Norman, OK 73071
Phone (405) 307-1500

4050 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 608-3200

9600 Broadway Ext
Oklahoma City, OK 73114
Phone (405) 486-2100

1201 Health Center Pkwy
Yukon, OK 73099
Phone (405) 717-6800

Organizations & group practices 8

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": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1720074081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 HIDDEN MEADOW DR",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730649684",
            "telephone_number": "405-376-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 HIDDEN MEADOW DR",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730649684",
            "telephone_number": "405-376-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JAMES",
        "middle_name": "R.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OK",
            "license": "3657",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OK",
            "license": "3657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100103050C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mustang, OK

Sources for this page

Verify at the official NPI Registry.