Tyler Randall Davis, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

329162 Issued in LA

Practice address

4864 Jackson St
Monroe, LA 71202-6400

Phone

(318) 330-7000

NPI assigned

Mar 29, 2019

Last updated

May 16, 2023By the provider in NPPES

Sex

Male

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

Enrolled in LA

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

Specialty

Emergency Medicine

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cross Lake Emergency Group, LLCGroup PAC ID 5395096440, 60 clinicians

Hospital Service District No. 1 of Caldwell ParishGroup PAC ID 4587552450, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111
• Citizens Medical Center Hospital, Columbia, LA, CCN 190184

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Cross Lake Emergency Group, LLC

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1013497114
  Medicare reassignment Care Compare group NPD
• Hospital Service District No. 1 of Caldwell Parish

  dba Citizens Medical Center

  • General Acute Care Hospital
  • Columbia, LA
  • NPI 1306865761

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Highland Emergency Group, LLC

  • Emergency Medicine Physician
  • Shreveport, LA
  • NPI 1154913861
  Medicare reassignment NPD
• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222

  Emergency Medicine

  Medicare reassignment NPD
• Hospital Service District No. 1 Caldwell Parish

  dba Citizens Specialty Clinic

  • Orthopaedic Surgery Physician
  • Columbia, LA
  • NPI 1508692104
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospital Service District No. 1 Caldwell Parish

  dba Citizens Specialty Clinic

  • Orthopaedic Surgery Physician
  • Columbia, LA
  • NPI 1508692104

  Hospital

  Care Compare affiliation
• Hospital Service District No. 1 of Caldwell Parish

  dba Citizens Medical Center

  • General Acute Care Hospital
  • Columbia, LA
  • NPI 1306865761
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Bossier Health Center

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba Willis Knighton South Hospital

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  dba WK Pierremont Health Center

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1972064160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 W KIRBY PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711033822",
            "telephone_number": "318-626-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4864 JACKSON ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712026400",
            "telephone_number": "318-330-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TYLER",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "329162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Davis
• Shetoquie Davis
• Steven Jacob Davis
• Stevens Davis Jr., LPC-S, LMFT
• Tia Davis, MHS
• Willie Davis
• Woodrow Davis, CIT 5881
• Liz Sophia Dawkins, BA
• Dalal Dawud
• Melissa Anne De la O, AU.D.

• Emergency Medicine Physician in Monroe, LA
• Providers in Monroe, LA by specialty
• Emergency Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.