Individual provider Active NPI

Kristina L Davis, PA-C

  • Physician Assistant
  • Springdale, AR
National Provider Identifier
1801333174
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6823 Isaacs Orchard Rd
Springdale, AR 72762-6096
Phone
(479) 750-2080
Fax
(479) 750-2082
NPI assigned
Jan 25, 2017
Last updated
Oct 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Medical Physician Assistant 363AM0700X 2772 OK

Addresses

Primary practice location

6823 Isaacs Orchard Rd
Springdale, AR 72762-6096

Mailing address

1200 Childrens Ave
Oklahoma City, OK 73104-4637
Phone (405) 271-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170807000313 AR Practitioner - Physician Assistant 8628349883 Reassigns benefits to 1 organization
I20241123000088 OK Practitioner - Physician Assistant 8628349883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ou Health Partners IncGroup PAC ID 5991105876, 1,167 clinicians

Practice addresses (Care Compare)

4444 E 41St St
1St Floor Suite B Ou Health Physicians
Tulsa, OK 74135-2527
Phone (918) 619-4400

800 NE 10TH St
Ouhp Stephenson Cancer Center
Oklahoma City, OK 73104-5418
Phone (405) 271-1112

825 NE 10TH St
Oklahoma City, OK 73104-5417
Phone (405) 271-4700

900 NE 10TH St
Ouhp Family Medicine
Oklahoma City, OK 73104-5420
Phone (572) 244-0065

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Nov 11, 2024 Accepting new patients
Roller Weight Loss Institute Inc CurrentSince Aug 3, 2020 Accepting new patients
PWWL Centers, LLC PastSince Dec 10, 2023 Accepting new patients

Locations

1695 E Rainforest Rd
Fayetteville, AR 72703
Phone (479) 445-6460

1200 Childrens Ave
Oklahoma City, OK 73104
Phone (405) 271-2429

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

Organizations & group practices 4

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 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": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1801333174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CHILDRENS AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731044637",
            "telephone_number": "405-271-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6823 ISAACS ORCHARD RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626096",
            "telephone_number": "479-750-2080",
            "fax_number": "479-750-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KRISTINA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "2772",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.