AMANDA BLAKE DAVIS (APRN) – Family Nurse Practitioner, NPI 1790220143

AMANDA BLAKE DAVIS (APRN) is a healthcare provider. based in Fort smith, Arkansas. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 118856 (OK). The NPI Number for AMANDA BLAKE DAVIS (APRN) is 1790220143

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
AMANDA BLAKE DAVIS (APRN)
NPI
1790220143
Phone
(479) 242-2888
Address
3416 OLD GREENWOOD RD
Enumeration Date
21 December 2016
Last Update Date
9 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4792422888
Graduation Year
2016 (10 years ago)
PAC ID
6002199882
Group Practice PAC ID
1557672409
Professional Enrollment ID
I20180530001861
Address ID
AR729035462FO3416XRDXX400
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:9State licenses:2Digital endpointsOther names

3,410 NURSE PRACTITIONER in AR

Provider Addresses for AMANDA BLAKE DAVIS (APRN)

  • 3416 OLD GREENWOOD RD

    FORT SMITH, AR 729035462

    Phone: (479) 242-2888

    Fax: (479) 242-2889

    Type: Location

  • 2125 PARKRIDGE DR

    VAN BUREN, AR 729567491

    Phone: (479) 226-0979

    Fax: (479) 242-2889

    Type: Mailing

  • 1109, East Cherokee Avenue, Sallisaw, Sequoyah County, Oklahoma, 74955, United States

    SALLISAW, OK 749555035

    Phone: (187) 903-3099

    Fax: (918) 775-0587

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 117 Open Payments records for all available years, with a total value of $37,245.

Total Amount is formed as General ($37,245) + Research ($0) + Ownership ($0) = $37,245.

Last reported payment date: 2024-11-27 • Largest payer in this snapshot: Gilead Sciences, Inc. ($33,513).

Total Amount

$37,245

General + Research + Ownership

Payments

117

Total payment records

General Amount

$37,245

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-27

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-05-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180530001861INurse PractitionerARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes7763$0
99213Established patient office or other outpatient visit, 20-29 minutes4034$0
99203New patient office or other outpatient visit, 30-44 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 72903)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557672409View full group profile
NameSpecialtyState
Gastroenterology, Internal MedicineAR
Internal Medicine, GastroenterologyAR
Certified Registered Nurse Anesthetist (Crna)TX

Reviews

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Frequently asked questions

How do I look up AMANDA BLAKE DAVIS (APRN) by NPI?
Use NPI 1790220143 when you need to reference AMANDA BLAKE DAVIS (APRN) in forms, claims, or directories.
Is AMANDA BLAKE DAVIS (APRN)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does AMANDA BLAKE DAVIS (APRN) treat or focus on?
Patients typically see AMANDA BLAKE DAVIS (APRN) under the specialty Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location shows for AMANDA BLAKE DAVIS (APRN)?
We surface Fort Smith, Arkansas for AMANDA BLAKE DAVIS (APRN) based on available NPPES addresses.
What if Fort Smith, Arkansas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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