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KELLY VAN DAVIS M.D.
NPI 1871554139
Internal Medicine in Wagoner, OK

Active since March 28, 2006PECOS EnrolledAccepts Medicare Assignment
1202 W CHEROKEE ST STE H, WAGONER, OK 74467(918) 614-5533(918) 485-6020 Get Directions Write a Review

NPPES record last updated: October 14, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 14, 2022, Aug 7, 2020, Jun 29, 2020 and 1 more (4 updates tracked since 2016).

About Kelly Van Davis M.d. NPPES

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

KELLY VAN DAVIS M.D. (NPI 1871554139) is an individual internal medicine provider in Wagoner, Oklahoma, licensed in Oklahoma (23418) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Council Oak Comprehensive Healthcare, and is a graduate of Other (2003).

NPPES Registry Identity

NPI1871554139
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameKELLY VAN DAVISCredential: M.D.
Location Address1202 W CHEROKEE ST STE HWagoner, OK 74467-4629
Mailing Address10907 S Knoxville AveTulsa, OK 74137-6624 · (918) 978-5588 · Fax (918) 299-0323
Phone(918) 614-5533
Fax(918) 485-6020
Sole ProprietorNo
Medical School CMSOtherGraduated 2003
Enumeration DateMarch 28, 2006
Last NPPES UpdateOctober 14, 20224 updates tracked since enumeration
NPPES CertifiedOctober 14, 2022
✔ NPI 1871554139 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in OK · 23418
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X · License 23418 (OK)
Also ListedInternal Medicine · RheumatologyTaxonomy 207RR0500X · License 23418 (OK)
1202 W CHEROKEE ST STE H, Wagoner, OK 74467
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly Van Davis M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002824323
PECOS Enrollment IDI20130122000230
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Council Oak Comprehensive Healthcare

Acute Care Hospitals · Tulsa, OK
OwnershipTribal
CMS Certification Number370244
Location10109 E 79th StTulsa, OK 74133 · Tulsa County

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74467 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$123.06 typical visit price
range $53.00 – $162.61
Typical copayment $30.76 (range $13.25 – $40.65)
Most-billed visit code 99204
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier12 claims12 services$207.14 avg. paid by Medicare
Addition to lower extremity orthosis, suspension sleeve L2397
DME-Orthotic Devices · category DF000N
7 suppliers27 claims37 services$89.32 avg. paid by Medicare
Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf L3916
DME-Orthotic Devices · category DF000N
6 suppliers11 claims18 services$398.36 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

FARMER FAMILY PRACTICE
Clinic/Center
1202 W CHEROKEE ST STE H
WAGONER, OK 74467
Wagoner County (918) 485-7020
JENNIFER ANNE FARMER ARNP-CNP
Nurse Practitioner
1202 W CHEROKEE ST STE H
WAGONER, OK 74467
Wagoner County (918) 485-7020

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 Kelly Davis's NPI number?

The NPI number for Kelly Davis is 1871554139. It was assigned to this individual provider in the NPPES registry on March 28, 2006.

Where is Kelly Davis located?

Kelly Davis practices at 1202 W Cherokee St Ste H, Wagoner, OK 74467. The listed phone number is (918) 614-5533.

What is Kelly Davis's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Kelly Davis enrolled in Medicare?

Yes. Kelly Davis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kelly Davis accept?

Health plans from Blue Cross and Blue Shield of Oklahoma and UnitedHealthcare list Kelly Davis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Kelly Davis affiliated with any hospitals?

According to CMS data, Kelly Davis is affiliated with Council Oak Comprehensive Healthcare.

When was this NPI record last updated?

The NPPES record for Kelly Davis was last updated on October 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.