Active NPI
Christy Lynn Davis, APRN-CNP
- Neonatal Nurse Practitioner
- Tulsa, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- R0112502
- Practice address
- 1120 S Utica Ave Ste 2123
Tulsa, OK 74104-4012 - Phone
- (918) 579-5402
- Fax
- (918) 579-5404
- NPI assigned
- Sep 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 2018009258 | MO | |
| Neonatal Nurse Practitioner | 363LN0000X | R66633 | AR | |
| Neonatal Nurse Practitioner | 363LN0000X | R0112502 | OK | Primary |
Addresses
Primary practice location
1120 S Utica Ave Ste 2123
Tulsa, OK 74104-4012
Mailing address
1120 S Utica Ave Ste 2123
Tulsa, OK 74104-4012
Phone (918) 579-5402
Other practice location 1
100 Mercy Way
Joplin, MO 64804-4524
Phone (417) 556-6428
Other names 1
- Christy Lynn Sullivan
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R66633 | AR | MD | Neonatal Nurse Practitioner |
| R0112502 | OK | MD | Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Joplin LLC | Current | Accepting new patients |
Locations
1717 S Range Line Rd
Ste B
Joplin, MO 64804
Phone (417) 556-2231
100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300
9735 Landmark Parkway Dr
Saint Louis, MO 63127
Phone (314) 842-6223
1120 S Utica Ave
Ste 2123
Tulsa, OK 74104
Phone (918) 579-5402
Interoperability endpoints
- christy.davis@direct.stjohnhealthsystem.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.
-
- Family Medicine Physician
- Joplin, MO
- NPI 1215264817
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522886400000",
"number": "1821499336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 S UTICA AVE STE 2123",
"city": "TULSA",
"state": "OK",
"postal_code": "741044012",
"telephone_number": "918-579-5402",
"fax_number": "918-579-5404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 S UTICA AVE STE 2123",
"city": "TULSA",
"state": "OK",
"postal_code": "741044012",
"telephone_number": "918-579-5402",
"fax_number": "918-579-5404"
}
],
"practiceLocations": [
{
"address_1": "100 Mercy Way",
"address_purpose": "LOCATION",
"city": "Joplin",
"state": "MO",
"postal_code": "648044524",
"country_code": "US",
"telephone_number": "417-556-6428",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVIS",
"first_name": "CHRISTY",
"middle_name": "LYNN",
"credential": "APRN-CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-16",
"last_updated": "2018-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "MO",
"license": "2018009258",
"primary": false
},
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "AR",
"license": "R66633",
"primary": false
},
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "OK",
"license": "R0112502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHRISTY",
"last_name": "SULLIVAN",
"middle_name": "LYNN",
"code": "1",
"type": "Former Name"
}
]
}
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 Apr 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.