NPIMap

Individual provider Active NPI

Dustin Wayne Davis, D.O.

  • Family Medicine Physician
  • Talihina, OK
National Provider Identifier
1992155626
Registry record updated Dec 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7059 Issued in OK
Practice address
1 Choctaw Way
Talihina, OK 74571-2022
Phone
(918) 567-7000
NPI assigned
Jun 14, 2016
Last updated
Dec 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7059 OK Primary
Surgery Physician 208600000X BP10055359 TX

Addresses

Primary practice location

1 Choctaw Way
Talihina, OK 74571-2022

Mailing address

1801 Chukka Hina
Durant, OK 74701-7117
Phone (580) 920-2100

Other practice location 1

900 8th Ave
Plaza Medical Center
Fort Worth, TX 76104
Phone (817) 336-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OK2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200810001684 TX Practitioner - Family Practice 8921423807 Reassigns benefits to 1 organization
I20201209003273 OK Practitioner - Family Practice 8921423807 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choctaw Nation of OklahomaGroup PAC ID 1759294838, 271 clinicians
Elite Integral Staffing LLCGroup PAC ID 0648612341, 15 clinicians

Practice addresses (Care Compare)

1 Choctaw Way
Talihina, OK 74571-2022
Phone (539) 316-6391

1800 W University Blvd
Durant, OK 74701-3006
Phone (719) 688-1483

901 S 5TH Ave
Madill, OK 73446-3640
Phone (719) 688-1483

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.07 of 100Reported as group
Quality
73.06
Improvement activities
40
Cost
69.92

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10055359TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choctaw Nation of Oklahoma CurrentSince Aug 4, 2020 Accepting new patients
Elite Integral Staffing LLC CurrentSince Dec 1, 2024 Accepting new patients
Choctaw Nation of Oklahoma Current Accepting new patients
Arbuckle Memorial Hospital Current Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Aug 4, 2020 Accepting new patients
Hospital Care Consultants, Inc CurrentSince Jul 1, 2024 Accepting new patients
Marshall County Hma, LLC Past Accepting new patients
Sequoyah County City of Sallisaw Hospital Authority Past Accepting new patients

Locations

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

1800 W University Blvd
Durant, OK 74701
Phone (580) 924-3080

1801 Chukka Hina
Durant, OK 74701
Phone (580) 920-2100

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (918) 423-8440

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

213 E Redwood Ave
Sallisaw, OK 74955
Phone (918) 774-1100

905 S Main St
Shattuck, OK 73858
Phone (580) 938-2551

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

2011 W Broadway Ave
Sulphur, OK 73086
Phone (580) 622-2161

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

17304 Preston Rd
Ste 1400
Dallas, TX 75252
Phone (972) 934-3200

Interoperability endpoints

  • Direct secure messaging: ddavis21511@choctawnation.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703289600000",
    "number": "1992155626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 CHUKKA HINA",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747017117",
            "telephone_number": "580-920-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHOCTAW WAY",
            "city": "TALIHINA",
            "state": "OK",
            "postal_code": "745712022",
            "telephone_number": "918-567-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 8th Ave",
            "address_2": "Plaza Medical Center",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "76104",
            "country_code": "US",
            "telephone_number": "817-336-2100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "DUSTIN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2023-12-23",
        "certification_date": "2023-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "7059",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "BP10055359",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Talihina, OK

Sources for this page

Verify at the official NPI Registry.