Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Mary Lou Davis

Physician β€’ Miami, OK

Deactivated NPI 1487886339 Deactivated in NPPES Female Practitioner
Practice location in NPPES

130 W Steve Owens Blvd
Miami, OK 743547629

Phone: 9185422845

Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

This NPI Is Deactivated in NPPES

NPPES lists this NPI as deactivated as of June 17, 2019; the reason is not published. The records below are historical. They do not show whether Mary Davis currently practices or holds a license; check the state medical board for current license status.

NPI Enumeration Date August 11, 2009
NPI Deactivation Date June 17, 2019
NPI Active Period 2009 – 2019

Practice Location & Contact Primary Location

Practice Address

130 W Steve Owens Blvd

Miami, OK 743547629

Telephone 9185422845
Fax 9185422848
Organization at the Same NPPES Address or Phone
Northeastern Oklahoma Council On Alcoholism, Inc. Facility NPI 1336346279

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2009

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Compared with the same specialty in Miami and Oklahoma

Comparisons are not shown because NPPES lists this NPI as deactivated.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Substance Abuse Rehabilitation Facility Primary Specialty

NUCC Taxonomy Code: 324500000X

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oklahoma State Board of Medical Licensure.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
⚠️
NPI Profile Deactivated June 17, 2019

NPPES lists this NPI as deactivated as of June 17, 2019; the reason is not published.

βœ…
NPI Profile Active August 11, 2009

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 11, 2009

Registered at 130 W STEVE OWENS BLVD, MIAMI, OK 743547629 (Tel: 9185422845)

πŸ“
Business Mailing Address (Initial Record) August 11, 2009

Registered at PO BOX 1271, MIAMI, OK 743551271 (Tel: 9185422845)

πŸ‘€
Provider Name / Credentials (Initial Record) August 11, 2009

Recorded as MARY DAVIS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 11, 2009

Substance Abuse Rehabilitation Facility

🟒
Initial NPI Registration & Enumeration August 11, 2009

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1487886339
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 11, 2009
Last Update: August 11, 2009
Deactivation Date: June 17, 2019

Mailing Address

Po Box 1271

Miami, OK 743551271

Phone: 9185422845

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.