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OTIS MCKINNLEY DAVIS IV MD
NPI 1386447852
Student in an Organized Health Care Education/Training Program in Little Rock, AR

Active since March 31, 2025PECOS Enrolled
4301 W MARKHAM ST # 634, LITTLE ROCK, AR 72205(501) 686-7592 Get Directions Write a Review

NPPES record last updated: March 31, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Otis Mckinnley Davis Iv Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OTIS MCKINNLEY DAVIS IV MD (NPI 1386447852) is an individual student in an organized health care education/training program in Little Rock, Arkansas and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1386447852
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameOTIS MCKINNLEY DAVIS IVCredential: MD
Location Address4301 W MARKHAM ST # 634Little Rock, AR 72205-7101
Mailing Address4214 C StLittle Rock, AR 72205-4056 · (501) 548-5632
Phone(501) 686-7592
Sole ProprietorYes
Enumeration DateMarch 31, 2025
NPPES CertifiedMarch 30, 2025
✔ NPI 1386447852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
4301 W MARKHAM ST # 634, Little Rock, AR 72205
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Other Names 1

Other Name (5)Braeden Davis

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Otis Mckinnley Davis Iv Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MU'NES ALBADAINEH MD
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 634
LITTLE ROCK, AR 72205
Pulaski County (501) 313-9501
GRANT ROBINSON MD
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 634
LITTLE ROCK, AR 72205
Pulaski County (501) 686-5162
VIDHI DIPAK BHANUSHALI
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 634
LITTLE ROCK, AR 72205
Pulaski County (501) 686-7592
DHARMIKKUMAR BHARATBHAI JADVANI
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 634
LITTLE ROCK, AR 72205
Pulaski County (501) 686-5545
LINA MOHAMMAD SUBHI ALQIREM MD
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 634
LITTLE ROCK, AR 72205
Pulaski County (501) 646-5545
LEONARD FERDMAN
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 634
LITTLE ROCK, AR 72205
Pulaski County (501) 686-7592
DR. ETHAN SETH SMITH MD
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 634
LITTLE ROCK, AR 72205
Pulaski County (501) 686-5545
SHUNG MING CHIU MBBS
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 634
LITTLE ROCK, AR 72205
Pulaski County (501) 686-5545

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Otis Davis's NPI number?

The NPI number for Otis Davis is 1386447852. It was assigned to this individual provider in the NPPES registry on March 31, 2025. The provider is also known as Braeden Davis.

Where is Otis Davis located?

Otis Davis practices at 4301 W Markham St # 634, Little Rock, AR 72205. The listed phone number is (501) 686-7592.

What is Otis Davis's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Otis Davis enrolled in Medicare?

Yes. Otis Davis is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Otis Davis was last updated on March 31, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.