Etta Pearl Davis

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

4638 SE 29TH St
Del City, OK 73115-3429

Phone

(405) 670-4644

Fax

(405) 670-4444

NPI assigned

Mar 1, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1831463371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4638 SE 29TH ST",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731153429",
            "telephone_number": "405-670-4644",
            "fax_number": "405-670-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4638 SE 29TH ST",
            "city": "DEL CITY",
            "state": "OK",
            "postal_code": "731153429",
            "telephone_number": "405-670-4644",
            "fax_number": "405-670-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ETTA",
        "middle_name": "PEARL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa A Cooper, M.S.
• Karen Robbins Cox, MS LMFT
• Rosalind Cravens, MT-BC
• Daniel Max & Marc Andrea LLC
• Tessie Danker
• Jennifer Renee Davis, APRN-CNP
• David Evans De Gaston, M.D.
• Seana Dean, M.D.
• Deep Thoughts and Wellness Center
• Del City Nursing Center, LLC

• All providers in Del City, OK
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.